CMS Formulary

Displaying 3351-3360 of 1611142 results.
ID: 3351
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 763489
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3352
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 996559
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3353
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 762833
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3354
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 762836
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3355
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 762839
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3356
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 762843
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3357
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 762875
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3358
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 762849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3359
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 762852
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3360
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 762859
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0