CMS Formulary

Displaying 40451-40460 of 1611142 results.
ID: 40451
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 313306
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40452
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 348472
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40453
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 282401
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40454
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 198427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40455
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 198428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40456
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 198429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40457
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 152695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40458
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 854905
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40459
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 854901
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40460
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 313762
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30