CMS Formulary

Displaying 3501-3510 of 1611142 results.
ID: 3501
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048568
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3502
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2478437
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3503
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099956
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3504
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058926
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3505
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047602
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 3506
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047608
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 3507
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047614
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 3508
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047596
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 3509
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047623
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 3510
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463737
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28