CMS Formulary

Displaying 14281-14290 of 1611142 results.
ID: 14281
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 284496
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14282
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 855926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14283
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 855906
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 14284
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 855664
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 14285
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 995281
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14286
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095227
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14287
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1304988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14288
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 14289
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309079
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14290
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1438778
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0