CMS Formulary

Displaying 40991-41000 of 1611142 results.
ID: 40991
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 403884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40992
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 310599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40993
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 856535
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40994
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 856569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40995
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 856460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40996
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 856481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40997
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 860654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 40998
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 199450
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 40999
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 246172
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 41000
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30