CMS Formulary

Displaying 43841-43850 of 1611142 results.
ID: 43841
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 997229
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 43842
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 997223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 43843
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 993503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43844
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 993518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43845
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 898723
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43846
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 898687
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43847
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 898690
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43848
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 898719
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43849
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 857169
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43850
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 857183
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0