CMS Formulary

Displaying 4631-4640 of 1611142 results.
ID: 4631
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 309683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4632
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012021
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4633
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 849506
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4634
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797863
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 25
ID: 4635
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 213262
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4636
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 545259
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4637
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4638
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 850309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4639
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310015
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4640
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1150836
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0