CMS Formulary

Displaying 4071-4080 of 1611142 results.
ID: 4071
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 486146
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4072
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 577057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 4073
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437702
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 4074
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 857002
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 4075
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 857005
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 4076
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 856999
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 4077
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 993781
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 4078
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049221
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 4079
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049225
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 4080
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30