CMS Formulary

Displaying 4701-4710 of 1611142 results.
ID: 4701
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 351172
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4702
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199422
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4703
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 200082
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4704
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199663
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4705
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 905199
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4706
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 905225
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4707
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 905395
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4708
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4709
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197817
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 4710
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197818
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30