CMS Formulary

Displaying 4041-4050 of 1611142 results.
ID: 4041
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 830865
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4042
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 830869
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4043
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 830872
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4044
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 260350
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4045
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 260351
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4046
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4047
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4048
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 4049
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4050
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111641
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30