CMS Formulary

Displaying 44391-44400 of 1611142 results.
ID: 44391
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551923
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 44392
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601373
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 44393
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 44394
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 44395
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 853356
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 44396
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 848164
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 44397
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653144
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 44398
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482814
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 44399
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653166
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 44400
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100079
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30