CMS Formulary

Displaying 14301-14310 of 1611142 results.
ID: 14301
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607784
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14302
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199245
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14303
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199246
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14304
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199247
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14305
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 314231
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14306
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312961
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14307
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198211
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14308
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 200060
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14309
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 317573
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14310
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312440
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30