CMS Formulary

Displaying 45011-45020 of 1611142 results.
ID: 45011
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 724863
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 45012
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 724859
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 45013
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 724861
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 45014
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 403818
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45015
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 897021
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 45016
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049264
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 45017
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1856424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45018
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45019
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 861375
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45020
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 861370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0