CMS Formulary

Displaying 34191-34200 of 1611142 results.
ID: 34191
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 403878
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 34192
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098143
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34193
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200174
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34194
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200177
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34195
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200180
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34196
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34197
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648755
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34198
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 725021
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34199
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 725023
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34200
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 311994
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30