CMS Formulary

Displaying 39451-39460 of 1611142 results.
ID: 39451
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197595
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39452
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39453
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 309958
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39454
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 309960
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39455
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 884707
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 39456
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 753543
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39457
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110455
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 39458
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1314763
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39459
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 312594
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39460
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 198141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0