CMS Formulary

Displaying 40711-40720 of 1611142 results.
ID: 40711
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197623
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40712
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055650
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 40713
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099808
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40714
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484296
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40715
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190919
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40716
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244205
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40717
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 830470
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40718
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300310
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40719
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40720
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300191
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0