CMS Formulary

Displaying 4801-4810 of 1611142 results.
ID: 4801
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2381144
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4802
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 465355
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4803
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 979099
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4804
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 967023
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4805
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 967012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4806
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4807
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4808
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 4809
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 4810
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30