CMS Formulary

Displaying 14511-14520 of 1611142 results.
ID: 14511
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 809871
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 14512
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 864661
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14513
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001424
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14514
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363408
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 14515
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363410
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 14516
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364581
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 14517
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790175
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14518
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790167
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14519
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14520
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928941
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30