CMS Formulary

Displaying 49171-49180 of 1611142 results.
ID: 49171
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 106346
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 220
Qty Limit Days: 30
ID: 49172
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098649
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49173
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098670
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49174
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098674
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49175
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49176
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923426
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49177
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49178
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 904589
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49179
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 894859
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49180
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 866042
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0