CMS Formulary

Displaying 4131-4140 of 1611142 results.
ID: 4131
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 751616
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4132
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 827075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4133
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 833151
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4134
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 833139
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4135
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 833143
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4136
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 833149
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4137
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 833146
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4138
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4139
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4140
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433229
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30