CMS Formulary

Displaying 41091-41100 of 1611142 results.
ID: 41091
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605455
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41092
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649946
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41093
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649964
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41094
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 993456
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 180
ID: 41095
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1046402
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41096
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649491
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41097
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649495
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41098
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168596
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41099
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045638
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 41100
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 2120195
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30