CMS Formulary

Displaying 33111-33120 of 1611142 results.
ID: 33111
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 896027
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 33112
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 896023
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 33113
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 213484
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33114
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 759473
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 180
ID: 33115
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 896185
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 33116
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 896212
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 33117
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 896229
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 33118
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 896237
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 33119
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 896245
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 33120
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 896273
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30