CMS Formulary

Displaying 4991-5000 of 1611142 results.
ID: 4991
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4992
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 4993
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4994
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4995
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197986
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4996
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 860215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4997
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 860221
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 4998
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 349194
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 4999
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 349195
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 5000
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 349198
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30