CMS Formulary

Displaying 45471-45480 of 1611142 results.
ID: 45471
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178409
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 28
ID: 45472
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2382991
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 45473
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2382993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 45474
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272630
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45475
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272622
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45476
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272636
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45477
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272624
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45478
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2282414
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 45479
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283236
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 45480
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 848333
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84