CMS Formulary

Displaying 43981-43990 of 1611142 results.
ID: 43981
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939299
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 43982
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939348
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 43983
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 577324
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43984
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 727316
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 43985
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870207
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 43986
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 1374574
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 43987
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003255
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 43988
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 2198370
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 43989
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 865208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 43990
Formulary ID: 00021015
Formulary Version: 14
Contract Year: 2021
RXCUI: 865212
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30