CMS Formulary

Displaying 40641-40650 of 1611142 results.
ID: 40641
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 309072
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40642
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 863538
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40643
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40644
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 240209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40645
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 318202
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 40646
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 238600
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40647
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 310465
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 40648
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40649
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40650
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0