CMS Formulary

Displaying 4241-4250 of 1611142 results.
ID: 4241
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 977880
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4242
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047882
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4243
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310190
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4244
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4245
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 261178
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4246
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4247
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 106303
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4248
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313450
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4249
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313451
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4250
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 308508
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0