CMS Formulary

Displaying 35721-35730 of 1611142 results.
ID: 35721
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272624
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35722
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2282414
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 35723
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283236
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 35724
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 848333
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 35725
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 848343
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 35726
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665906
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 35727
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665900
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 35728
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801322
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 28
ID: 35729
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2262446
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 35730
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123034
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0