CMS Formulary

Displaying 3901-3910 of 1611142 results.
ID: 3901
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 904583
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3902
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 904593
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3903
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 848951
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3904
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 834346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3905
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 993466
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3906
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 993470
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3907
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 993462
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3908
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047868
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 3909
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 834350
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3910
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801299
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0