CMS Formulary

Displaying 40461-40470 of 1611142 results.
ID: 40461
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 313761
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 40462
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 884173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40463
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 884185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40464
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 884189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40465
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40466
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 996571
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 40467
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 996561
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 40468
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 854916
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40469
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 854919
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40470
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 854908
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0