CMS Formulary

Displaying 4751-4760 of 1611142 results.
ID: 4751
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4752
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4753
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4754
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4755
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 809871
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 4756
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 864661
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4757
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001424
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4758
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363408
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 4759
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363410
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 4760
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364581
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28