CMS Formulary

Displaying 42581-42590 of 1611142 results.
ID: 42581
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 845518
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 42582
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 845512
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 42583
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 847734
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42584
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 860244
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 42585
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1002300
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 42586
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 998191
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 42587
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012899
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 42588
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1119402
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 42589
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310138
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 42590
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310144
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28