CMS Formulary

Displaying 4671-4680 of 1611142 results.
ID: 4671
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4672
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 616539
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4673
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 616541
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4674
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4675
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4676
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4677
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310289
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4678
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855858
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4679
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4680
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 348472
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0