CMS Formulary

Displaying 38091-38100 of 1611142 results.
ID: 38091
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 860805
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38092
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111343
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38093
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 284008
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 38094
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 313919
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 38095
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797865
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 34
Qty Limit Days: 28
ID: 38096
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797867
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 25
ID: 38097
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 860107
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 25
ID: 38098
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 904481
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38099
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 617312
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38100
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 617310
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0