CMS Formulary

Displaying 39761-39770 of 1611142 results.
ID: 39761
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373491
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 39762
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 856797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39763
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 866491
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39764
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197963
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39765
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 856825
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39766
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 313354
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39767
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 198274
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39768
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 198275
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39769
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 198270
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39770
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197960
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0