CMS Formulary

Displaying 3881-3890 of 1611142 results.
ID: 3881
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1246306
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3882
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1246290
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3883
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666334
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3884
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116639
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3885
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872261
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3886
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3887
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 991233
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3888
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 308047
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3889
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 308048
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3890
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197321
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30