CMS Formulary

Displaying 45151-45160 of 1611142 results.
ID: 45151
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 198189
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45152
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 261962
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45153
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 199147
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45154
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 349491
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45155
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649990
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45156
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45157
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 198201
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45158
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 728109
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 180
ID: 45159
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 312122
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 180
ID: 45160
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 200346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0