CMS Formulary

Displaying 42911-42920 of 1611142 results.
ID: 42911
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 991233
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42912
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 308047
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 42913
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 308048
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 42914
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197321
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 42915
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197322
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 42916
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 198033
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42917
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42918
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42919
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197816
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 42920
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197815
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0