CMS Formulary

Displaying 4881-4890 of 1611142 results.
ID: 4881
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085644
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4882
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1014314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4883
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085686
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4884
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 151030
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4885
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 977990
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4886
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 977978
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4887
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 309289
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 4888
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 309291
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 19
Qty Limit Days: 30
ID: 4889
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 895487
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4890
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 895987
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0