CMS Formulary

Displaying 39941-39950 of 1611142 results.
ID: 39941
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197635
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 39942
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197634
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 39943
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 238154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 39944
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 309844
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 39945
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39946
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39947
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39948
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39949
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 39950
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0