CMS Formulary

Displaying 4171-4180 of 1611142 results.
ID: 4171
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 238154
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 4172
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 309844
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 4173
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4174
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4175
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4176
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4177
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 4178
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197516
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4179
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197517
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4180
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 996740
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30