CMS Formulary

Displaying 3941-3950 of 1611142 results.
ID: 3941
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 3942
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3943
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3944
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 3945
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 3946
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2387331
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 3947
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486981
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3948
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486977
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3949
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940498
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 3950
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593831
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30