CMS Formulary

Displaying 32301-32310 of 1611142 results.
ID: 32301
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602028
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 32302
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602034
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 32303
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602040
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 32304
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602046
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 32305
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265729
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 32306
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265732
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 32307
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265735
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 32308
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809643
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 32309
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809499
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 32310
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1495070
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28