CMS Formulary

Displaying 46721-46730 of 1611142 results.
ID: 46721
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 403890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 46722
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 197549
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 46723
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 197550
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 46724
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102717
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 46725
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102713
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 46726
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 46727
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2475840
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 560
Qty Limit Days: 28
ID: 46728
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107621
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 46729
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 46730
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0