CMS Formulary

Displaying 3591-3600 of 1611142 results.
ID: 3591
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169322
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 3592
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362240
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3593
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169320
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 3594
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362244
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3595
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365866
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3596
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3597
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873991
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 3598
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873993
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 28
ID: 3599
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873995
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 3600
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1421456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0