CMS Formulary

Displaying 38011-38020 of 1611142 results.
ID: 38011
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38012
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2373941
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38013
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049677
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38014
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 762675
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38015
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 259966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38016
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 197973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38017
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 401953
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38018
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38019
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 616698
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 38020
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 616705
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30