CMS Formulary

Displaying 39481-39490 of 1611142 results.
ID: 39481
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860137
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 39482
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860148
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 39483
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 835894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39484
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 835925
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39485
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 241834
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39486
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1368954
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39487
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 349094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39488
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 351109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39489
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39490
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0