CMS Formulary

Displaying 14061-14070 of 1611142 results.
ID: 14061
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 836368
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 28
ID: 14062
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1552004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 14063
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723478
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14064
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430453
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14065
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430457
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14066
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100706
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14067
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430449
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14068
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1592748
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14069
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1592752
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14070
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243033
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30