CMS Formulary

Displaying 48921-48930 of 1611142 results.
ID: 48921
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 905164
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48922
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 688242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48923
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 208513
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48924
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 404550
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48925
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 150840
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48926
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 208949
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48927
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 202301
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48928
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000491
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48929
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000497
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48930
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000499
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0