CMS Formulary

Displaying 33221-33230 of 1611142 results.
ID: 33221
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 33222
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 861045
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 33223
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 861043
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 33224
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33225
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 801357
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33226
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 801112
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33227
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 801136
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33228
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799706
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33229
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 805131
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33230
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 801648
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0