CMS Formulary

Displaying 41-50 of 1611142 results.
ID: 41
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601660
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992428
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 213282
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 44
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 213283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 213284
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 46
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 859865
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 47
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 352297
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 731328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0