CMS Formulary

Displaying 38521-38530 of 1611142 results.
ID: 38521
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 656660
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38522
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989085
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 38523
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442143
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 38524
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729053
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 38525
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729057
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38526
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729061
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38527
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729065
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38528
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729013
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38529
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729029
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38530
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729033
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30