CMS Formulary

Displaying 34781-34790 of 1611142 results.
ID: 34781
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 197782
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34782
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 197783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34783
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 313142
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34784
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 312347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34785
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048450
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34786
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020065
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 34787
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34788
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 855626
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 34789
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 855194
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34790
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607617
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30