CMS Formulary

Displaying 36571-36580 of 1611142 results.
ID: 36571
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 36572
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 36573
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 36574
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 199689
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 36575
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 603208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 36576
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 603203
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 36577
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 36578
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 36579
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 751901
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 36580
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84