CMS Formulary

Displaying 4681-4690 of 1611142 results.
ID: 4681
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 282401
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4682
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4683
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4684
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4685
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 152695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4686
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 854905
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4687
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 854901
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4688
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313762
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4689
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313761
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4690
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 884173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0