CMS Formulary

Displaying 38701-38710 of 1611142 results.
ID: 38701
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 312830
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38702
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 312831
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38703
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 312832
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38704
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 314211
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38705
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 199890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38706
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 845488
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38707
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 861736
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 38708
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 861740
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 38709
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 312817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38710
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 577315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0