CMS Formulary

Displaying 14081-14090 of 1611142 results.
ID: 14081
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546083
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 14082
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796091
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14083
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796096
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14084
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862688
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14085
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862701
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14086
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862697
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14087
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862692
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14088
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1037181
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14089
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1037049
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14090
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 991082
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0