CMS Formulary

Displaying 14311-14320 of 1611142 results.
ID: 14311
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312441
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14312
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199123
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14313
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197956
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14314
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197958
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14315
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 200064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14316
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14317
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313190
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14318
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198377
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14319
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198378
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14320
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1483744
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0