CMS Formulary

Displaying 34681-34690 of 1611142 results.
ID: 34681
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114074
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34682
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114096
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34683
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 903841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34684
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 34685
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049504
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34686
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049545
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34687
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049565
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34688
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34689
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049586
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34690
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049595
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30