CMS Formulary

Displaying 40551-40560 of 1611142 results.
ID: 40551
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650143
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40552
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298910
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 40553
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298816
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 40554
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298906
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 40555
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 858613
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40556
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 858616
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40557
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 858747
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40558
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 891881
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 40559
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 891888
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 40560
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 891893
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30