CMS Formulary

Displaying 42401-42410 of 1611142 results.
ID: 42401
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1859000
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 42402
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604544
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 28
ID: 42403
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2002420
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 42404
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923338
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42405
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923347
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42406
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876406
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42407
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2375329
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42408
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099302
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42409
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003757
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42410
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003767
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0