CMS Formulary

Displaying 3851-3860 of 1611142 results.
ID: 3851
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 896245
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 3852
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 896273
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 3853
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 895996
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 3854
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 896001
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 3855
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 896006
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 3856
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539893
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3857
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487528
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3858
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547660
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3859
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547672
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3860
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720606
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28