CMS Formulary

Displaying 3081-3090 of 1611142 results.
ID: 3081
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 310005
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3082
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099681
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3083
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197682
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3084
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 866910
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3085
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 308867
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3086
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1092357
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3087
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665473
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3088
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1798370
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3089
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1798375
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3090
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 200132
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30