CMS Formulary

Displaying 43221-43230 of 1611142 results.
ID: 43221
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 977883
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43222
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197863
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43223
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197556
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43224
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197554
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43225
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197555
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43226
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 856369
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43227
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1009145
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 43228
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 687043
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 43229
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 577957
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 43230
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0