CMS Formulary

Displaying 3021-3030 of 1611142 results.
ID: 3021
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 801961
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3022
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 801966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3023
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 245723
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3024
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 830861
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3025
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 830845
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3026
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 830837
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3027
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 830801
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3028
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 352257
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 3029
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2393794
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 3030
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121764
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30