CMS Formulary

Displaying 48701-48710 of 1611142 results.
ID: 48701
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 208083
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48702
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054275
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 48703
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2275613
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 48704
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 48705
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 48706
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272126
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 48707
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2394947
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 48708
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199304
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48709
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199308
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48710
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199312
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0