CMS Formulary

Displaying 48851-48860 of 1611142 results.
ID: 48851
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988675
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 48852
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1924315
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48853
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486841
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48854
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 798300
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48855
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 830253
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48856
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 830245
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48857
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 836636
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48858
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 836634
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48859
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365
ID: 48860
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597103
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365