CMS Formulary

Displaying 3231-3240 of 1611142 results.
ID: 3231
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191250
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3232
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 207373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3233
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245268
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 3234
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 314088
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3235
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 403914
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3236
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3237
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3238
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922763
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3239
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3240
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0