CMS Formulary

Displaying 4741-4750 of 1611142 results.
ID: 4741
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 314154
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4742
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 283639
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4743
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 200284
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4744
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4745
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 351108
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4746
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 349251
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4747
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 905041
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4748
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 4749
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 4750
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0