CMS Formulary

Displaying 46121-46130 of 1611142 results.
ID: 46121
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 213484
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 46122
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 759473
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 180
ID: 46123
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 896185
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 46124
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 896212
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 46125
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 896229
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 46126
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 896237
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 46127
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 896245
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 46128
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 896273
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 46129
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 895996
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 46130
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 896001
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28