CMS Formulary

Displaying 4311-4320 of 1611142 results.
ID: 4311
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430449
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4312
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1592748
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4313
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1592752
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4314
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243033
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4315
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243040
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4316
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243026
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4317
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1545664
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4318
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1545668
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4319
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1651275
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 4320
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664321
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30