CMS Formulary

Displaying 4781-4790 of 1611142 results.
ID: 4781
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298816
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 4782
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298906
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 4783
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 858613
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4784
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 858616
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4785
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 858747
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4786
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 891881
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 4787
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 891888
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 4788
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 891893
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4789
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 891874
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4790
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 892646
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30