CMS Formulary

Displaying 40291-40300 of 1611142 results.
ID: 40291
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40292
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40293
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40294
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 861601
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40295
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 861597
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40296
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 615882
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40297
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 284496
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40298
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 855926
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 40299
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 855906
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 40300
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 855664
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30