CMS Formulary

Displaying 3731-3740 of 1611142 results.
ID: 3731
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313993
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3732
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310293
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3733
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310294
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3734
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 314000
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3735
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310536
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3736
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310539
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3737
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3738
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3739
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299909
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3740
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197737
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0