CMS Formulary

Displaying 3701-3710 of 1611142 results.
ID: 3701
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 721773
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 3702
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 476179
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 3703
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 476177
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 3704
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199703
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3705
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359129
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3706
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 485440
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3707
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860157
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3708
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860129
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3709
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860137
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3710
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860148
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30