CMS Formulary

Displaying 45451-45460 of 1611142 results.
ID: 45451
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2275613
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 45452
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 45453
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 45454
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272126
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 45455
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2394947
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 45456
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199304
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45457
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199308
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45458
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199312
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45459
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199316
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45460
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 206883
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0