CMS Formulary

Displaying 38341-38350 of 1611142 results.
ID: 38341
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876673
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38342
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876674
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38343
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38344
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 866111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38345
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 198252
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38346
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649593
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 38347
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546189
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 38348
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2261794
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 38349
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38350
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 858804
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0