CMS Formulary

Displaying 14401-14410 of 1611142 results.
ID: 14401
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 204423
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14402
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14403
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 314165
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14404
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 226343
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14405
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14406
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 308493
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14407
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14408
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310594
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14409
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 905379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14410
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30