CMS Formulary

Displaying 3961-3970 of 1611142 results.
ID: 3961
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 805131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3962
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 801648
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3963
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 800420
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3964
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 800405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3965
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090639
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3966
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 800438
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3967
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 800444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3968
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 801012
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3969
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 801000
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3970
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 801021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0