CMS Formulary

Displaying 14621-14630 of 1611142 results.
ID: 14621
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 795749
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14622
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809520
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14623
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 239189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14624
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665107
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14625
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309072
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14626
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 863538
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14627
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14628
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 240209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14629
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 318202
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 14630
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 238600
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0