CMS Formulary

Displaying 34061-34070 of 1611142 results.
ID: 34061
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34062
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34063
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34064
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34065
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34066
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34067
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1491624
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34068
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468316
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 34069
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2381144
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34070
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 465355
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0