CMS Formulary

Displaying 38941-38950 of 1611142 results.
ID: 38941
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999314
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38942
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999316
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38943
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058520
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 38944
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058525
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 38945
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 208083
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38946
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054275
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 38947
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2275613
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 38948
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 38949
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 38950
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272126
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30