CMS Formulary

Displaying 34031-34040 of 1611142 results.
ID: 34031
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34032
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928941
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 34033
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34034
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34035
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34036
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 829500
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34037
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 861025
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 765
Qty Limit Days: 30
ID: 34038
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 881341
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34039
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 199690
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34040
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 197417
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0