CMS Formulary

Displaying 40651-40660 of 1611142 results.
ID: 40651
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 40652
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 543546
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 40653
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085644
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40654
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1014314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40655
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085686
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40656
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 151030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40657
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 977990
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40658
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 977978
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40659
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 309289
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 40660
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 309291
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 19
Qty Limit Days: 30