CMS Formulary

Displaying 3391-3400 of 1611142 results.
ID: 3391
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 863829
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3392
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373327
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3393
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 905164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3394
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 688242
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3395
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 208513
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3396
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 404550
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3397
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 150840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3398
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 208949
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3399
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 202301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3400
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000491
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0