CMS Formulary

Displaying 4461-4470 of 1611142 results.
ID: 4461
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4462
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4463
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4464
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4465
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540356
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4466
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 992475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4467
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 995258
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4468
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297753
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4469
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297757
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4470
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049621
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30