CMS Formulary

Displaying 3481-3490 of 1611142 results.
ID: 3481
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057205
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3482
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057216
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3483
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057212
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3484
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057219
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3485
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099952
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 3486
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105860
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3487
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2469340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3488
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 637188
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365
ID: 3489
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 795735
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365
ID: 3490
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 637190
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365