CMS Formulary

Displaying 39151-39160 of 1611142 results.
ID: 39151
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2002420
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 39152
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923338
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39153
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923347
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39154
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876406
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39155
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2375329
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39156
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099302
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39157
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003757
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39158
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003767
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39159
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797880
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39160
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1113046
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0