CMS Formulary

Displaying 35281-35290 of 1611142 results.
ID: 35281
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2261800
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 35282
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799001
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35283
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790317
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35284
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 727714
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35285
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 314230
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35286
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 861646
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 35287
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 861650
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 35288
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 861654
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 35289
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 30
ID: 35290
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 349591
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30