CMS Formulary

Displaying 4791-4800 of 1611142 results.
ID: 4791
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 848726
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4792
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 848738
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4793
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4794
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4795
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4796
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4797
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4798
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4799
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1491624
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4800
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468316
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30