CMS Formulary

Displaying 43011-43020 of 1611142 results.
ID: 43011
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 310670
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43012
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373483
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 7
ID: 43013
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373491
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 43014
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 856797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43015
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 866491
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43016
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197963
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43017
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 856825
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43018
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 313354
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43019
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 198274
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43020
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 198275
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0