CMS Formulary

Displaying 34051-34060 of 1611142 results.
ID: 34051
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 858613
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34052
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 858616
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34053
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 858747
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34054
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 891881
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 34055
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 891888
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 34056
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 891893
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34057
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 891874
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34058
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 892646
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34059
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 848726
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34060
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 848738
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30