CMS Formulary

Displaying 40241-40250 of 1611142 results.
ID: 40241
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297757
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40242
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049621
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 40243
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2101899
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40244
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049683
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 40245
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049686
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 40246
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091150
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 40247
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 899557
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 40248
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 899518
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 40249
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 899548
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 40250
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091133
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30