CMS Formulary

Displaying 39881-39890 of 1611142 results.
ID: 39881
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39882
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 309090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39883
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 309092
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39884
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665005
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39885
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 311683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39886
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 727575
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39887
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040012
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39888
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040016
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39889
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653470
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39890
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086776
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30