CMS Formulary

Displaying 48461-48470 of 1611142 results.
ID: 48461
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 199890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48462
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 845488
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48463
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 861736
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 48464
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 861740
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 48465
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 312817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48466
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 577315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48467
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48468
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 836395
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 48469
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 833234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48470
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0