CMS Formulary

Displaying 44371-44380 of 1611142 results.
ID: 44371
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 579148
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 44372
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 104894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 44373
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 861132
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 44374
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 310352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 44375
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 44376
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 44377
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 44378
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 44379
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 313582
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 44380
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 313584
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0