CMS Formulary

Displaying 35231-35240 of 1611142 results.
ID: 35231
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 349200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35232
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 200224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35233
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 898350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35234
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 898353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35235
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 898356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35236
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 898359
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35237
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 898342
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35238
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 898346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35239
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 863669
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35240
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 313581
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30