CMS Formulary

Displaying 48991-49000 of 1611142 results.
ID: 48991
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 198146
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48992
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 213272
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48993
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 207100
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48994
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 804547
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 48995
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307630
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 48996
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307635
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 48997
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243010
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 48998
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243014
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 48999
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601394
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 49000
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601386
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28