CMS Formulary

Displaying 33411-33420 of 1611142 results.
ID: 33411
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307309
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 33412
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052609
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33413
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052704
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33414
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105817
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 33415
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300797
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33416
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300803
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33417
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 967388
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33418
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 307730
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33419
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 106302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33420
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 884308
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30