CMS Formulary

Displaying 4101-4110 of 1611142 results.
ID: 4101
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 307719
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4102
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 831430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4103
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807516
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4104
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665210
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4105
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 239209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4106
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4107
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860139
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4108
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 800192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4109
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665021
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4110
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 309090
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0