CMS Formulary

Displaying 4521-4530 of 1611142 results.
ID: 4521
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4522
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 861601
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4523
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 861597
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4524
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 615882
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4525
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 284496
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4526
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4527
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855906
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 4528
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855664
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 4529
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 995281
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4530
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095227
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0