CMS Formulary

Displaying 4401-4410 of 1611142 results.
ID: 4401
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 349556
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4402
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 240741
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4403
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 309322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4404
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 476576
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4405
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 617423
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4406
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 617993
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4407
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 314227
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 4408
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 142046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4409
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 238004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 4410
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313921
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30