CMS Formulary

Displaying 43211-43220 of 1611142 results.
ID: 43211
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 905369
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 43212
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 311166
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43213
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197832
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43214
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 349196
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 43215
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 349197
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 43216
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 905516
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 43217
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 905495
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 43218
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 835913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43219
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43220
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 995232
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0