CMS Formulary

Displaying 42351-42360 of 1611142 results.
ID: 42351
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 830253
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42352
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 830245
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42353
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 836636
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42354
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 836634
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42355
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365
ID: 42356
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597103
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365
ID: 42357
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1292443
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42358
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 804186
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42359
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1292459
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 365
ID: 42360
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658106
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0