CMS Formulary

Displaying 49361-49370 of 1611142 results.
ID: 49361
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 197589
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 49362
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 197391
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49363
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 197392
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49364
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 597852
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49365
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 597850
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49366
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 310273
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49367
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 284245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49368
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 835886
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49369
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 866049
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 49370
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 896019
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30