CMS Formulary

Displaying 42451-42460 of 1611142 results.
ID: 42451
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874559
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 42452
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874553
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 42453
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 900575
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42454
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 977427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42455
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 977434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42456
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 977438
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42457
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 892625
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 42458
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 311355
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42459
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197893
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42460
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 313932
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0