CMS Formulary

Displaying 3811-3820 of 1611142 results.
ID: 3811
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049380
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 3812
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986354
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 3813
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986356
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 3814
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205454
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 3815
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653198
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 3816
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 977842
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 3817
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 977840
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 3818
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 897126
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 3819
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2398842
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 3820
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991311
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28