CMS Formulary

Displaying 33921-33930 of 1611142 results.
ID: 33921
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 905379
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33922
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 33923
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791560
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 33924
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791569
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 33925
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 33926
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 33927
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812015
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33928
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 862006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33929
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 862013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 33930
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 862019
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0