CMS Formulary

Displaying 3301-3310 of 1611142 results.
ID: 3301
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3302
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3303
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547575
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3304
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547110
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3305
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3306
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3307
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3308
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3309
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3310
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0