CMS Formulary

Displaying 3521-3530 of 1611142 results.
ID: 3521
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1855527
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3522
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921240
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3523
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3524
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726846
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3525
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 847745
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 3526
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872980
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3527
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747577
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3528
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747579
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3529
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747567
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 3530
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747580
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0