CMS Formulary

Displaying 34121-34130 of 1611142 results.
ID: 34121
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 796918
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34122
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649996
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 34123
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650004
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 34124
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 582984
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34125
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122661
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34126
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122659
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34127
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122657
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34128
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122655
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34129
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122650
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34130
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122648
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0