CMS Formulary

Displaying 43351-43360 of 1611142 results.
ID: 43351
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796096
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 43352
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862688
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 43353
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862701
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 43354
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862697
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 43355
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862692
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 43356
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1037181
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 43357
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1037049
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 43358
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 991082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43359
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 702519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43360
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 314182
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0