CMS Formulary

Displaying 40501-40510 of 1611142 results.
ID: 40501
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 859424
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 40502
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 859747
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 40503
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 859751
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 40504
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 859419
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 40505
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40506
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40507
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40508
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 40509
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 40510
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 349201
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0