CMS Formulary

Displaying 3001-3010 of 1611142 results.
ID: 3001
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 644088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 3002
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603861
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 3003
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3004
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3005
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3006
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989507
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3007
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876920
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3008
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876924
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3009
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876916
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3010
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111642
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30