CMS Formulary

Displaying 43831-43840 of 1611142 results.
ID: 43831
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43832
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 43833
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 43834
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 43835
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 43836
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43837
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 312846
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43838
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 283858
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43839
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 562704
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43840
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 312849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0