CMS Formulary

Displaying 45511-45520 of 1611142 results.
ID: 45511
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 403914
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45512
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45513
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45514
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922763
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45515
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45516
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45517
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 45518
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 45519
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364494
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 45520
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30