CMS Formulary

Displaying 35021-35030 of 1611142 results.
ID: 35021
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604352
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35022
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 825335
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35023
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 825333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35024
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 825325
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35025
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 825334
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35026
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 212118
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35027
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 542370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35028
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988768
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 35029
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 35030
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988772
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30