CMS Formulary

Displaying 42611-42620 of 1611142 results.
ID: 42611
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656356
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42612
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1859501
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 42613
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1919094
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 42614
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169314
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 42615
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169322
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 42616
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362240
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 42617
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169320
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 42618
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362244
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 42619
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365866
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42620
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656351
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0