CMS Formulary

Displaying 3161-3170 of 1611142 results.
ID: 3161
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283515
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 3162
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283518
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 3163
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283509
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3164
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283513
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3165
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283538
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3166
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3167
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283540
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3168
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 311944
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3169
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3170
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0