CMS Formulary

Displaying 42571-42580 of 1611142 results.
ID: 42571
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42572
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946522
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42573
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 727705
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42574
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655728
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42575
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 825170
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42576
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801278
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42577
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 847741
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 42578
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 835892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42579
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42580
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 746609
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28