CMS Formulary

Displaying 3041-3050 of 1611142 results.
ID: 3041
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3042
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1495070
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 3043
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 199888
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3044
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 151226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3045
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 199889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3046
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 311486
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3047
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 904396
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 3048
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 199672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3049
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 252559
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3050
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 239238
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0