CMS Formulary

Displaying 4811-4820 of 1611142 results.
ID: 4811
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4812
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4813
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312846
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4814
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 283858
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4815
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 562704
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4816
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312849
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4817
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 997229
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4818
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 997223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4819
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 993503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4820
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 993518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0