CMS Formulary

Displaying 3621-3630 of 1611142 results.
ID: 3621
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 866094
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3622
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 866083
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3623
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 211817
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3624
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801283
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3625
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 978006
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3626
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 834022
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 3627
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 833217
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3628
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 831103
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3629
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 831102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3630
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 831054
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0