CMS Formulary

Displaying 4611-4620 of 1611142 results.
ID: 4611
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 861007
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 4612
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 861010
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 4613
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 861004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 75
Qty Limit Days: 30
ID: 4614
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 861731
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 4615
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 562524
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4616
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4617
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650142
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4618
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 353538
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4619
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 897666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4620
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099288
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0