CMS Formulary

Displaying 40401-40410 of 1611142 results.
ID: 40401
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 313888
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40402
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 309042
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40403
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 309683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40404
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40405
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 849506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40406
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797863
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 25
ID: 40407
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 213262
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40408
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 545259
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40409
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099503
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40410
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 850309
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0