CMS Formulary

Displaying 4841-4850 of 1611142 results.
ID: 4841
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4842
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 351223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 4843
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198070
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4844
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 401938
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 4845
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 751566
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4846
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 751568
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4847
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 751570
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4848
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 897044
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4849
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 758032
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 4850
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 758027
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28