CMS Formulary

Displaying 4191-4200 of 1611142 results.
ID: 4191
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 349197
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 4192
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 905516
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 4193
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 905495
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 4194
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 835913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4195
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000405
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4196
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 995232
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4197
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 977883
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4198
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197863
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4199
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197556
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4200
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197554
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0