CMS Formulary

Displaying 4381-4390 of 1611142 results.
ID: 4381
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000007
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 4382
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 309339
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4383
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 309335
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4384
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 309336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4385
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 308207
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4386
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4387
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 789980
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4388
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 828755
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4389
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 828539
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4390
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 545835
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0