CMS Formulary

Displaying 14571-14580 of 1611142 results.
ID: 14571
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 562704
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14572
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312849
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14573
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 997229
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14574
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 997223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14575
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 993503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14576
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 993518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14577
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 898723
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14578
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 898687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14579
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 898690
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14580
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 898719
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0