CMS Formulary

Displaying 41381-41390 of 1611142 results.
ID: 41381
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049227
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 41382
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049216
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 41383
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 854801
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41384
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 313477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41385
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 861200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41386
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000647
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41387
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41388
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000897
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41389
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41390
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 831109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0