CMS Formulary

Displaying 39891-39900 of 1611142 results.
ID: 39891
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086780
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 39892
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086786
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 39893
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307415
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 39894
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307421
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 39895
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1869699
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 39896
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805427
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 39897
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602588
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 39898
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805422
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 39899
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602594
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 39900
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858971
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0