CMS Formulary

Displaying 42331-42340 of 1611142 results.
ID: 42331
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 42332
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 42333
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 42334
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42335
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 42336
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547114
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 42337
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547118
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 42338
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235595
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42339
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235591
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42340
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 668606
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0