CMS Formulary

Displaying 3191-3200 of 1611142 results.
ID: 3191
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178403
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 3192
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178405
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 3193
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2382990
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 3194
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178407
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 32
Qty Limit Days: 28
ID: 3195
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178409
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 28
ID: 3196
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2382991
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 3197
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2382993
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 3198
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272630
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3199
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272622
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3200
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0