CMS Formulary

Displaying 4111-4120 of 1611142 results.
ID: 4111
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 309092
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4112
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665005
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4113
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 311683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4114
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 727575
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4115
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040012
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4116
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040016
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4117
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4118
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086776
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4119
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4120
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086786
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30