CMS Formulary

Displaying 34871-34880 of 1611142 results.
ID: 34871
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 310377
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34872
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 745462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34873
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 731566
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34874
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 731568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34875
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 731571
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34876
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 34877
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049227
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 34878
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049216
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 34879
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 854801
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 34880
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 313477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0