CMS Formulary

Displaying 3271-3280 of 1611142 results.
ID: 3271
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 207834
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3272
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1718936
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 3273
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745114
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3274
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 729234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3275
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 582971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3276
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 582976
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3277
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1435117
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 3278
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 351859
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 3279
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1731317
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 3280
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 643177
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30