CMS Formulary

Displaying 38311-38320 of 1611142 results.
ID: 38311
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 859871
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38312
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 204416
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38313
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722934
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38314
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38315
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795609
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38316
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38317
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 581531
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38318
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371050
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 38319
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371054
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 38320
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30