CMS Formulary

Displaying 39861-39870 of 1611142 results.
ID: 39861
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049611
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 39862
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049618
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 39863
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 245136
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 39864
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 245134
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 39865
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 245135
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 39866
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 39867
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870650
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39868
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 829762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39869
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39870
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1724338
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0