CMS Formulary

Displaying 3321-3330 of 1611142 results.
ID: 3321
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734642
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3322
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988671
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 3323
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988675
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 3324
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1924315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3325
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3326
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 798300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3327
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 830253
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3328
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 830245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3329
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 836636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3330
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 836634
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0