CMS Formulary

Displaying 4721-4730 of 1611142 results.
ID: 4721
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 200094
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4722
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 200095
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4723
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 200096
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4724
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4725
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197313
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4726
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313566
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4727
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 485434
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4728
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 485436
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4729
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 859424
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4730
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 859747
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30