CMS Formulary

Displaying 45901-45910 of 1611142 results.
ID: 45901
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 978006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45902
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 834022
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 45903
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 833217
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45904
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 831103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45905
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 831102
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45906
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 831054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45907
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 197724
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45908
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 197381
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45909
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 197379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 45910
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 904458
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0