CMS Formulary

Displaying 40781-40790 of 1611142 results.
ID: 40781
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486687
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40782
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40783
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40784
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 860225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40785
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430383
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40786
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40787
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40788
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1550536
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40789
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2104192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40790
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1994764
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0