CMS Formulary

Displaying 37041-37050 of 1611142 results.
ID: 37041
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 37042
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 861601
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 37043
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 861597
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 37044
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 615882
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 37045
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 284496
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 37046
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 855926
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 37047
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 855906
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 37048
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 855664
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 37049
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 995281
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 37050
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095227
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0