CMS Formulary

Displaying 41821-41830 of 1611142 results.
ID: 41821
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 198241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 41822
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 198242
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 41823
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 308136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41824
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41825
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 310432
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 41826
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 311880
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41827
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 317174
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 41828
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 312745
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 41829
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 616483
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 41830
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 312743
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30