CMS Formulary

Displaying 34791-34800 of 1611142 results.
ID: 34791
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 311345
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34792
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 198200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34793
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 351256
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34794
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 351257
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34795
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 310261
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34796
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 308459
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34797
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 141963
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34798
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000126
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 34799
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000153
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 34800
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 198232
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0