CMS Formulary

Displaying 14261-14270 of 1611142 results.
ID: 14261
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 317110
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14262
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14263
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 858625
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14264
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 855182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14265
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14266
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14267
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14268
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14269
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14270
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30