CMS Formulary

Displaying 3361-3370 of 1611142 results.
ID: 3361
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 762868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3362
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 762897
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3363
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1009341
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 3364
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3365
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595473
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3366
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595478
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3367
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595292
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3368
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1995479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3369
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3370
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268231
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30