CMS Formulary

Displaying 39461-39470 of 1611142 results.
ID: 39461
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 834046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39462
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 834040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39463
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197536
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 39464
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 429212
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 39465
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 309374
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 135
Qty Limit Days: 30
ID: 39466
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299917
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39467
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 995218
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39468
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 866090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39469
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 643066
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39470
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652084
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0