CMS Formulary

Displaying 4651-4660 of 1611142 results.
ID: 4651
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4652
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310594
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4653
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 905379
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4654
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4655
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791560
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4656
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791569
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4657
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 4658
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791582
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 4659
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812015
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4660
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 862006
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0