CMS Formulary

Displaying 39581-39590 of 1611142 results.
ID: 39581
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206092
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 39582
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 39583
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049380
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 39584
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986354
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 39585
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986356
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 39586
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205454
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 39587
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653198
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 39588
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 977842
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 39589
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 977840
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 39590
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 897126
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30