CMS Formulary

Displaying 34301-34310 of 1611142 results.
ID: 34301
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 198370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34302
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242819
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 56
ID: 34303
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242815
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 56
ID: 34304
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 616749
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34305
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 728231
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34306
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657212
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34307
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1735537
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34308
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 992403
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34309
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1735496
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34310
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30