CMS Formulary

Displaying 42691-42700 of 1611142 results.
ID: 42691
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 314234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42692
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 308177
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42693
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 598025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42694
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 617309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42695
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 617316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42696
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 617296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42697
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 636664
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42698
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 608328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42699
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 42700
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30