CMS Formulary

Displaying 38141-38150 of 1611142 results.
ID: 38141
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605075
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38142
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 314072
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 38143
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 244967
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38144
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 309680
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38145
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 309679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38146
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1376336
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38147
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 204874
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38148
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 313415
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38149
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006120
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38150
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2260709
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0