CMS Formulary

Displaying 40421-40430 of 1611142 results.
ID: 40421
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40422
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 308493
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40423
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40424
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 310594
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40425
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 905379
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40426
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 40427
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791560
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 40428
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791569
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 40429
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 40430
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30