CMS Formulary

Displaying 4001-4010 of 1611142 results.
ID: 4001
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4002
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 998671
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 4003
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 998675
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 4004
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 998679
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 4005
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000048
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4006
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312593
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4007
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 966220
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4008
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 966221
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4009
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 966222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4010
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 966253
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0