CMS Formulary

Displaying 14351-14360 of 1611142 results.
ID: 14351
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 308345
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14352
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197636
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14353
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 260243
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14354
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312641
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14355
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1312625
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14356
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365660
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14357
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365847
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14358
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365850
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14359
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090641
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14360
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 905222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0