CMS Formulary

Displaying 45211-45220 of 1611142 results.
ID: 45211
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 861736
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 45212
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 861740
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 45213
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 312817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45214
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 577315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45215
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45216
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 836395
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 45217
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 833234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45218
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45219
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45220
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0