CMS Formulary

Displaying 35171-35180 of 1611142 results.
ID: 35171
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925264
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 56
ID: 35172
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049343
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 365
ID: 35173
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 312941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35174
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 312938
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35175
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 308194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35176
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 308182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35177
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 283406
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35178
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 283407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35179
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 283485
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35180
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 756209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0