CMS Formulary

Displaying 32361-32370 of 1611142 results.
ID: 32361
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 311915
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 32362
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1725064
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 32363
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001439
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 32364
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 32365
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918242
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 32366
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862595
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 32367
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921589
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 32368
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862590
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 32369
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666542
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 32370
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 831246
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0