CMS Formulary

Displaying 14631-14640 of 1611142 results.
ID: 14631
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310465
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 14632
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085640
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14633
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085633
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14634
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14635
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 14636
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 543546
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14637
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085644
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14638
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1014314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14639
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085686
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14640
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 151030
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0