CMS Formulary

Displaying 43281-43290 of 1611142 results.
ID: 43281
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 311386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43282
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 311385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43283
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 314075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43284
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 310812
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43285
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 861427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43286
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 991086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43287
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 314006
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 43288
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 315107
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 43289
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 310489
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 43290
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 722122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30