CMS Formulary

Displaying 35241-35250 of 1611142 results.
ID: 35241
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 402246
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35242
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 402247
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35243
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 664741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35244
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 833528
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35245
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 722134
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35246
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 722137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35247
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 722126
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35248
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 722131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35249
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 860715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 35250
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 860695
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30