CMS Formulary

Displaying 39671-39680 of 1611142 results.
ID: 39671
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 904605
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39672
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 904571
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39673
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 904583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39674
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 904593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39675
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 848951
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39676
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 834346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39677
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 993466
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39678
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 993470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39679
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 993462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39680
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047868
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30