CMS Formulary

Displaying 40921-40930 of 1611142 results.
ID: 40921
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 861487
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40922
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992281
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40923
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 40924
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40925
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 857366
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 170
Qty Limit Days: 30
ID: 40926
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40927
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 848208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40928
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 848176
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40929
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 848178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40930
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 313200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0