CMS Formulary

Displaying 38921-38930 of 1611142 results.
ID: 38921
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661799
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 38922
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946589
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 32
Qty Limit Days: 30
ID: 38923
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1421461
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38924
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044928
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38925
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38926
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049884
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38927
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045959
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38928
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045961
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38929
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045958
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38930
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055286
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0