CMS Formulary

Displaying 34721-34730 of 1611142 results.
ID: 34721
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 404449
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34722
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 700418
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34723
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 404450
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34724
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242233
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 34725
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 616116
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 34726
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 616114
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 34727
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 643714
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 34728
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1429367
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 34729
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 34730
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369724
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28