CMS Formulary

Displaying 45171-45180 of 1611142 results.
ID: 45171
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45172
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1485332
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45173
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1543553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45174
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1422081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45175
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1427300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45176
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 748800
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45177
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1599949
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 45178
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 848180
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45179
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123072
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 17
Qty Limit Days: 30
ID: 45180
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 314076
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0