CMS Formulary

Displaying 4321-4330 of 1611142 results.
ID: 4321
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 4322
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665369
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4323
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664328
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4324
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664325
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4325
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546083
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 4326
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796091
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4327
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796096
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4328
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862688
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4329
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862701
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4330
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862697
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30