CMS Formulary

Displaying 33001-33010 of 1611142 results.
ID: 33001
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 310294
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 33002
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 314000
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33003
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 310536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33004
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 310539
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33005
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299903
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33006
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33007
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299909
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33008
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 197737
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33009
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 310534
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33010
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0