CMS Formulary

Displaying 40161-40170 of 1611142 results.
ID: 40161
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 828539
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40162
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 545835
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40163
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 645884
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40164
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 754508
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 40165
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197411
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40166
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 310600
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40167
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 403850
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40168
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 810090
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40169
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 403851
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40170
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 810083
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0