CMS Formulary

Displaying 3131-3140 of 1611142 results.
ID: 3131
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3132
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1941470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3133
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1941476
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3134
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1941473
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3135
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197698
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3136
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 856783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3137
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607796
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3138
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607792
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3139
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992873
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 3140
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2119706
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25