CMS Formulary

Displaying 35121-35130 of 1611142 results.
ID: 35121
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 427163
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35122
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 35123
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399895
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 35124
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399898
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 35125
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399901
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 35126
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 198013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35127
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 198012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35128
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797113
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 35129
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399904
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 35130
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0