CMS Formulary

Displaying 38361-38370 of 1611142 results.
ID: 38361
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 309955
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38362
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1117531
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 38363
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116758
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 30
ID: 38364
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440936
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38365
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 309077
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38366
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 313428
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38367
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 242680
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38368
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 205292
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38369
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 205290
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38370
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 315134
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0