CMS Formulary

Displaying 4921-4930 of 1611142 results.
ID: 4921
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659927
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4922
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046585
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 4923
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 403878
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 4924
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098143
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4925
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200174
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4926
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200177
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4927
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200180
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4928
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4929
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4930
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 725021
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30