CMS Formulary

Displaying 3911-3920 of 1611142 results.
ID: 3911
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 832731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3912
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801295
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3913
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 3914
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3915
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197541
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 3916
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 753478
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3917
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 753479
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3918
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3919
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091828
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3920
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0