CMS Formulary

Displaying 4691-4700 of 1611142 results.
ID: 4691
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 884185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4692
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 884189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4693
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099625
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4694
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 996571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4695
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 996561
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4696
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 854916
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4697
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 854919
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4698
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 854908
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4699
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 201708
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4700
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 248420
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0