CMS Formulary

Displaying 3871-3880 of 1611142 results.
ID: 3871
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178077
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3872
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3873
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 995278
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3874
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 995253
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3875
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198228
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3876
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 852913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3877
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 993536
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3878
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 852877
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3879
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197979
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3880
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197978
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0