CMS Formulary

Displaying 3241-3250 of 1611142 results.
ID: 3241
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 3242
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3243
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364494
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 3244
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3245
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046597
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 228
Qty Limit Days: 14
ID: 3246
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989117
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 3247
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178792
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 3248
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 644304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3249
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3250
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861661
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0