CMS Formulary

Displaying 34611-34620 of 1611142 results.
ID: 34611
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 834061
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34612
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 834102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34613
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 310436
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34614
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 310437
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34615
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 579148
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34616
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 104894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34617
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 861132
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34618
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 310352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34619
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34620
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30