CMS Formulary

Displaying 43721-43730 of 1611142 results.
ID: 43721
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 854919
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43722
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 854908
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43723
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 201708
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43724
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 248420
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43725
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 351172
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43726
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 199422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43727
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 200082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43728
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 199663
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43729
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 905199
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43730
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 905225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0