CMS Formulary

Displaying 3401-3410 of 1611142 results.
ID: 3401
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000497
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3402
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3403
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000500
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3404
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000487
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3405
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653579
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3406
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3407
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797833
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 3408
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797844
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 10
ID: 3409
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 885857
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3410
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 860901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 200
Qty Limit Days: 30