CMS Formulary

Displaying 38931-38940 of 1611142 results.
ID: 38931
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265701
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 38932
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283505
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 38933
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283515
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 38934
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283518
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 38935
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283509
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38936
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283513
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 38937
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283538
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38938
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283536
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38939
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283540
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38940
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 311944
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0