CMS Formulary

Displaying 4871-4880 of 1611142 results.
ID: 4871
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4872
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 240209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4873
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 318202
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 4874
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 238600
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4875
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310465
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 4876
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085640
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4877
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085633
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4878
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4879
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 4880
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 543546
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30