CMS Formulary

Displaying 43181-43190 of 1611142 results.
ID: 43181
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 43182
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 245314
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 43183
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 485968
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 43184
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 991061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43185
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 857683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43186
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43187
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 198202
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43188
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 857677
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43189
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245443
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43190
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0