CMS Formulary

Displaying 4431-4440 of 1611142 results.
ID: 4431
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4432
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855342
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4433
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4434
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4435
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809730
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4436
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809738
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4437
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809667
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4438
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 854228
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 4439
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 854235
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 4440
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 854238
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 30