CMS Formulary

Displaying 32681-32690 of 1611142 results.
ID: 32681
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 351267
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 32682
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 905172
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 32683
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 905168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 32684
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 892589
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 700
Qty Limit Days: 30
ID: 32685
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 894780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 32686
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 997287
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 32687
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 997296
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 32688
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 310792
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 32689
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 310793
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 32690
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 197624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0