CMS Formulary

Displaying 32331-32340 of 1611142 results.
ID: 32331
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 728113
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 180
ID: 32332
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 483442
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 32333
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 483448
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 32334
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 483446
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 32335
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 312515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 32336
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795598
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 32337
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1366192
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 32338
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796922
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 32339
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744001
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 32340
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744005
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0