CMS Formulary

Displaying 34001-34010 of 1611142 results.
ID: 34001
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34002
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34003
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34004
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34005
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34006
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 349201
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34007
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 200034
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34008
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 312078
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34009
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 314154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34010
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 283639
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30