CMS Formulary

Displaying 3611-3620 of 1611142 results.
ID: 3611
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 545293
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3612
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 207029
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3613
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 665022
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3614
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720881
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3615
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3616
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 207035
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3617
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 261101
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3618
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 847232
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 3619
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 285018
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 3620
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855178
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0