CMS Formulary

Displaying 35371-35380 of 1611142 results.
ID: 35371
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 309097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35372
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 309098
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35373
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 312940
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35374
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 309080
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35375
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 309081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35376
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 197452
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35377
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 197453
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35378
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 309110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35379
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 309113
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35380
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 200345
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30