CMS Formulary

Displaying 43051-43060 of 1611142 results.
ID: 43051
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 242333
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 43052
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 241527
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 43053
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 403922
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 43054
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 402109
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43055
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 834235
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 43056
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 834241
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 43057
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 359144
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43058
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 359145
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43059
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43060
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 242892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28