CMS Formulary

Displaying 40091-40100 of 1611142 results.
ID: 40091
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1651275
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 40092
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664321
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 40093
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 40094
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665369
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 40095
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664328
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 40096
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664325
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 40097
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546083
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 40098
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796091
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 40099
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796096
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 40100
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862688
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30