CMS Formulary

Displaying 4931-4940 of 1611142 results.
ID: 4931
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 725023
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4932
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 311994
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 4933
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 311995
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 4934
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648759
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 4935
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307061
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4936
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115698
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 180
ID: 4937
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1308569
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 4938
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 351209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4939
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197623
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4940
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055650
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28