CMS Formulary

Displaying 4901-4910 of 1611142 results.
ID: 4901
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4902
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 4903
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4904
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4905
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4906
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4907
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4908
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4909
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 755470
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4910
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 544452
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0