CMS Formulary

Displaying 3201-3210 of 1611142 results.
ID: 3201
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3202
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2282414
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3203
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283236
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3204
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 848333
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 3205
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 848343
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 3206
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665906
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 3207
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665900
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 3208
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801322
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 28
ID: 3209
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2262446
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3210
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123034
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0