CMS Formulary

Displaying 38691-38700 of 1611142 results.
ID: 38691
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 686924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38692
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 200032
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38693
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 979092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 38694
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738483
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38695
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738495
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38696
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38697
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38698
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 197412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38699
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 312828
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38700
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 312829
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30