CMS Formulary

Displaying 35161-35170 of 1611142 results.
ID: 35161
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801519
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 35162
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 35163
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 35164
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 35165
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 35166
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 11
Qty Limit Days: 28
ID: 35167
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596778
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35168
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 35169
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673278
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 35170
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673280
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28