CMS Formulary

Displaying 42471-42480 of 1611142 results.
ID: 42471
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 309371
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42472
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197577
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42473
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 343033
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42474
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197579
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42475
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197580
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42476
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197581
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42477
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197582
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42478
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42479
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 310429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42480
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197860
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0