CMS Formulary

Displaying 47381-47390 of 1611142 results.
ID: 47381
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739782
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 47382
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 795085
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 47383
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 849599
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 47384
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739770
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 47385
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251914
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 47386
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 722256
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 47387
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251918
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 47388
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 724142
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 47389
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 724156
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 47390
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251922
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30