CMS Formulary

Displaying 39551-39560 of 1611142 results.
ID: 39551
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197604
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39552
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197606
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39553
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 198089
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39554
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 198083
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39555
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 314055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39556
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655960
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39557
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 859824
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39558
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 309101
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39559
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 835840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39560
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 835809
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28