CMS Formulary

Displaying 14121-14130 of 1611142 results.
ID: 14121
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 206842
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14122
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14123
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 359296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14124
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 308212
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14125
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 403810
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 14126
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 403811
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 14127
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806195
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14128
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806179
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14129
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14130
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 308191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0