CMS Formulary

Displaying 46101-46110 of 1611142 results.
ID: 46101
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653204
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 46102
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 351926
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 46103
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 849851
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 46104
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 847247
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 46105
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 847348
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 46106
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 847245
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 46107
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 197590
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 46108
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 197591
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 46109
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 197589
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 46110
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 197391
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0