CMS Formulary

Displaying 14561-14570 of 1611142 results.
ID: 14561
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 967012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14562
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14563
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14564
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 14565
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 14566
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 14567
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14568
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14569
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312846
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14570
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 283858
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0