CMS Formulary

Displaying 43381-43390 of 1611142 results.
ID: 43381
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 198159
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43382
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191256
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43383
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 992459
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43384
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 311678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43385
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085728
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43386
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43387
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 628953
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43388
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 381056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43389
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 206842
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43390
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 198316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0