CMS Formulary

Displaying 4201-4210 of 1611142 results.
ID: 4201
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197555
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4202
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 856369
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4203
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1009145
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4204
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 687043
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4205
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 577957
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4206
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4207
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199159
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4208
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4209
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000141
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4210
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197658
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0