CMS Formulary

Displaying 48411-48420 of 1611142 results.
ID: 48411
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 312122
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 180
ID: 48412
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 200346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48413
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 308135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48414
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 309054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48415
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48416
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48417
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736656
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48418
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48419
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806684
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48420
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356074
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0