CMS Formulary

Displaying 43561-43570 of 1611142 results.
ID: 43561
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1537209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43562
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43563
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539953
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43564
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539955
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43565
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43566
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 904419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 43567
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 866436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43568
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 855633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43569
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607784
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43570
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 199245
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30