CMS Formulary

Displaying 43081-43090 of 1611142 results.
ID: 43081
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 43082
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43083
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 751901
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 43084
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 43085
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 749761
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 43086
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 748868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43087
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 759743
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43088
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43089
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43090
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 284191
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0