CMS Formulary

Displaying 38721-38730 of 1611142 results.
ID: 38721
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38722
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988319
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38723
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988324
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38724
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988330
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38725
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649401
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38726
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054979
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 38727
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054983
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 38728
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055016
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 38729
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055014
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 38730
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 197701
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0