CMS Formulary

Displaying 4121-4130 of 1611142 results.
ID: 4121
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307415
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4122
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307421
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4123
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1869699
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4124
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805427
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4125
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602588
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4126
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805422
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4127
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602594
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4128
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4129
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 751620
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4130
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 751623
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0