CMS Formulary

Displaying 4151-4160 of 1611142 results.
ID: 4151
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 106302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4152
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 884308
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4153
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 106387
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4154
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 308714
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 4155
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 755497
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4156
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 992765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4157
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 4158
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 245314
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 4159
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 485968
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4160
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 991061
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0