CMS Formulary

Displaying 4271-4280 of 1611142 results.
ID: 4271
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 897618
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4272
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 897624
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4273
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 897630
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4274
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312025
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4275
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198041
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4276
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 582926
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4277
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597123
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 4278
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597129
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 4279
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 238134
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 4280
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745091
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30