CMS Formulary

Displaying 35741-35750 of 1611142 results.
ID: 35741
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 2369403
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 35742
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1594673
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35743
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 905059
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 35744
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 905064
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 35745
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 905057
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 168
ID: 35746
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251334
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35747
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487076
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 35748
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 1368459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35749
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 751970
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 35750
Formulary ID: 00021010
Formulary Version: 14
Contract Year: 2021
RXCUI: 836358
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 312
Qty Limit Days: 30