CMS Formulary

Displaying 4181-4190 of 1611142 results.
ID: 4181
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 311369
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 4182
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482908
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4183
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806187
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4184
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806189
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4185
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806191
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4186
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806193
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4187
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 905369
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 4188
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 311166
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4189
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197832
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4190
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 349196
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30