CMS Formulary

Displaying 40131-40140 of 1611142 results.
ID: 40131
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 992459
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40132
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 311678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40133
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085728
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40134
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40135
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 628953
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40136
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 381056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40137
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 206842
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40138
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 198316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40139
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 359296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40140
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 308212
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0