CMS Formulary

Displaying 3091-3100 of 1611142 results.
ID: 3091
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 3092
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 199150
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 3093
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 311915
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3094
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1725064
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 3095
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001439
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 3096
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3097
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918242
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 3098
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862595
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3099
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921589
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3100
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862590
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30