CMS Formulary

Displaying 3781-3790 of 1611142 results.
ID: 3781
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198089
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3782
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198083
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3783
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 314055
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3784
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655960
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3785
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 859824
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3786
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 309101
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3787
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 835840
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3788
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 835809
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 3789
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3790
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 308189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0