CMS Formulary

Displaying 14171-14180 of 1611142 results.
ID: 14171
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 308962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14172
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 991039
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14173
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 991194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14174
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 991336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14175
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 991044
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14176
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 991188
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14177
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 584414
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14178
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 857297
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14179
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 857301
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14180
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 857305
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0