CMS Formulary

Displaying 3561-3570 of 1611142 results.
ID: 3561
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1002300
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 3562
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 998191
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 3563
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012899
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3564
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1119402
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 3565
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310138
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 3566
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310144
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 3567
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310147
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 3568
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364114
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3569
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364118
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3570
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364122
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30