CMS Formulary

Displaying 45701-45710 of 1611142 results.
ID: 45701
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 897657
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 45702
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049604
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1300
Qty Limit Days: 30
ID: 45703
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874559
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 45704
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874553
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 45705
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 900575
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45706
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 977427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45707
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 977434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45708
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 977438
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45709
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 892625
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 45710
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 311355
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0