CMS Formulary

Displaying 48761-48770 of 1611142 results.
ID: 48761
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245268
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 48762
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 314088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48763
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 403914
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48764
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48765
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48766
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922763
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48767
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48768
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48769
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 48770
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30