CMS Formulary

Displaying 14521-14530 of 1611142 results.
ID: 14521
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14522
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14523
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14524
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 829500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14525
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861025
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 765
Qty Limit Days: 30
ID: 14526
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 881341
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14527
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199690
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14528
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197417
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14529
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197418
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14530
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0