CMS Formulary

Displaying 3471-3480 of 1611142 results.
ID: 3471
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601394
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 3472
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601386
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 3473
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601390
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 3474
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1987734
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3475
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058922
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3476
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103175
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 3477
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103179
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3478
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 810075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3479
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 810079
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3480
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284108
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28