CMS Formulary

Displaying 14031-14040 of 1611142 results.
ID: 14031
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198041
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14032
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 582926
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14033
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597123
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 14034
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597129
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 14035
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 238134
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 14036
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745091
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 14037
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801289
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14038
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311892
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14039
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311893
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14040
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199521
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30