CMS Formulary

Displaying 3691-3700 of 1611142 results.
ID: 3691
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197536
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 3692
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 429212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 3693
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 309374
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 135
Qty Limit Days: 30
ID: 3694
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3695
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 995218
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3696
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 866090
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3697
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 643066
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3698
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652084
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3699
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006801
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 3700
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 996921
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30