CMS Formulary

Displaying 4831-4840 of 1611142 results.
ID: 4831
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4832
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4833
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 4834
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 403908
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4835
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198038
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4836
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198039
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4837
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198040
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4838
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010600
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4839
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4840
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30