CMS Formulary

Displaying 4571-4580 of 1611142 results.
ID: 4571
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312744
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 4572
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 616487
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 4573
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312962
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4574
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 349332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4575
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 351250
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4576
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 856834
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4577
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 856845
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4578
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 856853
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4579
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 856762
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4580
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 856773
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0