CMS Formulary

Displaying 34111-34120 of 1611142 results.
ID: 34111
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 198070
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34112
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 401938
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 34113
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 751566
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34114
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 751568
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34115
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 751570
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34116
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 897044
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34117
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 758032
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 34118
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 758027
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 34119
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650282
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34120
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 207836
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0