CMS Formulary

Displaying 14201-14210 of 1611142 results.
ID: 14201
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 403890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14202
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197549
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14203
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197550
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14204
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102717
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14205
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102713
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14206
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14207
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2475840
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 560
Qty Limit Days: 28
ID: 14208
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107621
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 14209
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14210
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0