CMS Formulary

Displaying 3011-3020 of 1611142 results.
ID: 3011
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487363
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 3012
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 308725
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 420
Qty Limit Days: 30
ID: 3013
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 855657
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3014
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812011
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3015
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3016
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 562806
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 3017
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 825130
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3018
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 3019
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3020
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0