CMS Formulary

Displaying 3971-3980 of 1611142 results.
ID: 3971
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 801031
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3972
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 866924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3973
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197465
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 3974
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197466
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 3975
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 856720
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3976
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198286
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3977
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298857
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3978
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197464
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 3979
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 856840
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 3980
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298861
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0