CMS Formulary

Displaying 38601-38610 of 1611142 results.
ID: 38601
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2257015
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38602
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044720
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 38603
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044726
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 38604
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044732
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 38605
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046376
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38606
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046380
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38607
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38608
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 311288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38609
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 311289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38610
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 387003
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0