CMS Formulary

Displaying 14461-14470 of 1611142 results.
ID: 14461
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 905199
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14462
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 905225
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14463
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 905395
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14464
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14465
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197817
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 14466
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197818
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 14467
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14468
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 855172
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14469
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 242679
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14470
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309313
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30