CMS Formulary

Displaying 14131-14140 of 1611142 results.
ID: 14131
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199119
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14132
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 864110
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14133
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 854302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14134
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1793916
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 14135
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657160
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 14136
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654630
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14137
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000007
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 14138
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309339
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14139
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309335
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14140
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0