CMS Formulary

Displaying 3721-3730 of 1611142 results.
ID: 3721
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490065
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3722
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199058
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3723
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 596843
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3724
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 308868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3725
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 403879
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3726
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 476556
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3727
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197535
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 3728
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310295
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3729
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310297
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3730
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313992
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30