CMS Formulary

Displaying 3571-3580 of 1611142 results.
ID: 3571
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653243
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3572
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1599797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3573
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603361
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3574
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603365
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3575
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603369
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3576
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3577
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425110
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 3578
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425118
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3579
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 867506
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3580
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425230
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30