CMS Formulary

Displaying 4411-4420 of 1611142 results.
ID: 4411
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 238003
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 4412
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 403923
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 4413
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 241946
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 4414
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4415
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 308962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4416
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 991039
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4417
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 991194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4418
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 991336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4419
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 991044
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4420
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 991188
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0