CMS Formulary

Displaying 48501-48510 of 1611142 results.
ID: 48501
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 349594
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 48502
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 349595
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 48503
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 608143
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 48504
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 608139
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 48505
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 897659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48506
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 897640
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48507
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 855480
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48508
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 855474
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48509
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 749860
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48510
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1094543
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0