CMS Formulary

Displaying 33771-33780 of 1611142 results.
ID: 33771
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 859044
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33772
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 859048
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33773
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 317110
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33774
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33775
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 858625
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33776
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 855182
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33777
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33778
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 33779
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 33780
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30