CMS Formulary

Displaying 4911-4920 of 1611142 results.
ID: 4911
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 597768
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4912
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 597770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4913
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 597772
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4914
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 403975
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4915
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 259306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4916
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799654
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4917
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 105292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4918
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053458
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4919
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199592
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 4920
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 805464
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28