CMS Formulary

Displaying 48841-48850 of 1611142 results.
ID: 48841
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547118
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 48842
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235595
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48843
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235591
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48844
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 668606
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48845
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 861821
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 48846
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 861771
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 48847
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729311
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 48848
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055766
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48849
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734642
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 48850
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988671
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28