CMS Formulary

Displaying 36261-36270 of 1611142 results.
ID: 36261
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 310534
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 36262
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 36263
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362712
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 36264
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 36265
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 308865
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 36266
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860154
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 36267
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860151
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 36268
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860127
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 36269
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 856448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 36270
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 856457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0