CMS Formulary

Displaying 32481-32490 of 1611142 results.
ID: 32481
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591943
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 32482
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799212
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 32483
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659183
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 32484
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659161
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 32485
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 32486
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467575
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 32487
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2472789
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 32488
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2478450
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 32489
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2369403
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 32490
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1594673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0