CMS Formulary

Displaying 4471-4480 of 1611142 results.
ID: 4471
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2101899
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4472
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049683
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 4473
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049686
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 4474
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091150
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 4475
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 899557
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4476
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 899518
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4477
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 899548
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4478
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091133
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 4479
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 863664
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4480
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006122
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0