CMS Formulary

Displaying 47401-47410 of 1611142 results.
ID: 47401
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193345
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 47402
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193349
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 47403
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193353
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 47404
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359344
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 47405
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359348
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 47406
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359340
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 47407
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2361300
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 47408
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2361296
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 47409
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 2174390
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 47410
Formulary ID: 00021016
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243052
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28