CMS Formulary

Displaying 35301-35310 of 1611142 results.
ID: 35301
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 35302
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 35303
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 861232
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 35304
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1367436
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 35305
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 352210
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35306
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 198175
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35307
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361615
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35308
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35309
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 861363
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35310
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 861365
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0