CMS Formulary

Displaying 4051-4060 of 1611142 results.
ID: 4051
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 4052
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 4053
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 4054
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199689
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4055
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 603208
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4056
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 603203
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4057
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 4058
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4059
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 751901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 4060
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84