CMS Formulary

Displaying 4761-4770 of 1611142 results.
ID: 4761
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790175
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4762
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790167
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4763
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4764
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928941
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 4765
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4766
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4767
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4768
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 829500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4769
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 861025
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 765
Qty Limit Days: 30
ID: 4770
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 881341
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0