CMS Formulary

Displaying 47971-47980 of 1611142 results.
ID: 47971
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 643019
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 47972
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 643022
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 47973
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 866482
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 47974
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 866479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 47975
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 349401
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 47976
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 349405
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 47977
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 205322
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 47978
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 205323
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 47979
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 403853
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 47980
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 403854
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0