CMS Formulary

Displaying 4331-4340 of 1611142 results.
ID: 4331
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862692
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4332
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1037181
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4333
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1037049
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4334
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 991082
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4335
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 702519
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4336
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 314182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4337
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 885219
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4338
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 885213
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4339
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049635
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 4340
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198086
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0