CMS Formulary

Displaying 34231-34240 of 1611142 results.
ID: 34231
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003255
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34232
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2198370
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34233
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 865208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34234
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 865212
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34235
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 865216
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34236
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 723827
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34237
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 729201
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34238
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 729203
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34239
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796079
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34240
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796083
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0