CMS Formulary

Displaying 3511-3520 of 1611142 results.
ID: 3511
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463733
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 3512
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3513
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168548
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3514
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3515
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3516
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148502
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3517
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168540
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3518
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 207088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3519
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049858
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 3520
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049862
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28