CMS Formulary

Displaying 34501-34510 of 1611142 results.
ID: 34501
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2279847
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 10
ID: 34502
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1001690
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34503
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2465556
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34504
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 905394
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34505
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34506
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1543069
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 34507
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34508
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34509
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34510
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 310152
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30