CMS Formulary

Displaying 48561-48570 of 1611142 results.
ID: 48561
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602028
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 48562
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602034
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 48563
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602040
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 48564
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602046
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 48565
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265729
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 48566
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265732
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 48567
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265735
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 48568
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809643
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48569
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809499
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48570
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1495070
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28