CMS Formulary

Displaying 4211-4220 of 1611142 results.
ID: 4211
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4212
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197657
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4213
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 541878
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4214
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 541892
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4215
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 577961
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4216
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 541363
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4217
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 751868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4218
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 751871
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4219
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 751870
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4220
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 762007
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0