CMS Formulary

Displaying 4441-4450 of 1611142 results.
ID: 4441
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 854241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 30
ID: 4442
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 854248
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4443
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 854245
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 30
ID: 4444
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 854252
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4445
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 403890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4446
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197549
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4447
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197550
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4448
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102717
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4449
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102713
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4450
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30