CMS Formulary

Displaying 4451-4460 of 1611142 results.
ID: 4451
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2475840
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 560
Qty Limit Days: 28
ID: 4452
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107621
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 4453
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4454
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4455
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4456
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4457
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4458
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 672571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4459
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4460
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0