CMS Formulary

Displaying 4731-4740 of 1611142 results.
ID: 4731
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 859751
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4732
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 859419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4733
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4734
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4735
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4736
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4737
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4738
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 349201
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4739
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 200034
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4740
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312078
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30