CMS Formulary

Displaying 37171-37180 of 1611142 results.
ID: 37171
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 37172
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 310594
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 37173
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 905379
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 37174
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 37175
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791560
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 37176
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791569
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 37177
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 37178
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 37179
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812015
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 37180
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 862006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0