CMS Formulary

Displaying 42111-42120 of 1611142 results.
ID: 42111
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665473
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 42112
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1798370
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 42113
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1798375
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 42114
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 200132
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 42115
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 42116
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 199150
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 42117
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 311915
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42118
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1725064
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 42119
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001439
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 42120
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0