CMS Formulary

Displaying 4491-4500 of 1611142 results.
ID: 4491
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 993890
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 4492
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 864718
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 4493
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197593
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4494
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199168
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4495
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312357
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4496
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4497
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2106334
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4498
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661220
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4499
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 854876
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4500
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30