CMS Formulary

Displaying 34351-34360 of 1611142 results.
ID: 34351
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 706831
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 34352
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 706827
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 34353
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 706829
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 34354
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 706825
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 34355
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 858074
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 34356
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 858051
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 34357
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 858057
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 34358
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 858055
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 34359
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 858053
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 34360
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2059017
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30