CMS Formulary

Displaying 46731-46740 of 1611142 results.
ID: 46731
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 46732
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 46733
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 46734
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 672571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 46735
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 46736
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 46737
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 46738
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 46739
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 46740
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30