CMS Formulary

Displaying 40341-40350 of 1611142 results.
ID: 40341
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197528
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 40342
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197529
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 40343
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 312744
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 40344
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 616487
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 40345
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 312962
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 40346
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 349332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40347
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 351250
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40348
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 856834
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40349
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 856845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40350
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 856853
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0