CMS Formulary

Displaying 42481-42490 of 1611142 results.
ID: 42481
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42482
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42483
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 105585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42484
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197931
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42485
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 312617
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42486
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 198144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42487
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 198146
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42488
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 213272
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42489
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 207100
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42490
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 804547
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0