CMS Formulary

Displaying 14021-14030 of 1611142 results.
ID: 14021
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310489
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14022
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 722122
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14023
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 722116
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14024
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198250
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14025
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197502
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14026
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 897612
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14027
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 897618
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14028
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 897624
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14029
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 897630
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14030
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312025
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0