CMS Formulary

Displaying 42891-42900 of 1611142 results.
ID: 42891
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 42892
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 249066
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42893
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 207840
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42894
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178081
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42895
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178077
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42896
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42897
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 995278
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42898
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 995253
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42899
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 198228
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42900
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 852913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0