CMS Formulary

Displaying 3671-3680 of 1611142 results.
ID: 3671
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 617316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3672
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 617296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3673
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 636664
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3674
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 608328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3675
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 3676
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3677
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 905032
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 3678
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090996
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3679
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197595
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3680
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197596
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0