CMS Formulary

Displaying 14411-14420 of 1611142 results.
ID: 14411
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791560
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14412
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791569
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14413
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 14414
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791582
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 14415
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812015
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14416
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 862006
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14417
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 862013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14418
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 862019
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14419
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 862025
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14420
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0