CMS Formulary

Displaying 14191-14200 of 1611142 results.
ID: 14191
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809730
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14192
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809738
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14193
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809667
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14194
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 854228
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 14195
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 854235
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 14196
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 854238
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 30
ID: 14197
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 854241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 30
ID: 14198
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 854248
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14199
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 854245
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 30
ID: 14200
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 854252
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30