CMS Formulary

Displaying 3641-3650 of 1611142 results.
ID: 3641
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 866018
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3642
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 603103
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3643
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 106346
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 220
Qty Limit Days: 30
ID: 3644
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098649
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3645
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098670
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3646
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098674
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3647
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923422
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3648
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923426
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3649
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923424
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3650
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 904589
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0