CMS Formulary

Displaying 4421-4430 of 1611142 results.
ID: 4421
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 584414
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4422
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 857297
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4423
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 857301
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4424
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 857305
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4425
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596780
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 4426
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4427
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4428
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4429
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4430
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0