CMS Formulary

Displaying 45681-45690 of 1611142 results.
ID: 45681
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653579
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45682
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 198148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45683
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797833
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 45684
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797844
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 10
ID: 45685
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 885857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45686
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 860901
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 200
Qty Limit Days: 30
ID: 45687
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 351265
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 45688
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 351266
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 45689
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 351267
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 45690
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 905172
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0