CMS Formulary

Displaying 41831-41840 of 1611142 results.
ID: 41831
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 312840
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 41832
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 314209
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 41833
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 199206
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 41834
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41835
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197806
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41836
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197807
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41837
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 311347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41838
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 311204
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 41839
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 41840
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0