CMS Formulary

Displaying 42051-42060 of 1611142 results.
ID: 42051
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 830801
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42052
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 352257
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 42053
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2393794
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 42054
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121764
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 42055
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2173841
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 42056
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364477
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42057
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602028
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 42058
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602034
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 42059
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602040
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 42060
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602046
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28