CMS Formulary

Displaying 43401-43410 of 1611142 results.
ID: 43401
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 854302
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43402
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1793916
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 43403
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657160
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 43404
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654630
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 43405
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000007
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 43406
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 309339
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43407
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 309335
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43408
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 309336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43409
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 308207
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43410
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721475
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0