CMS Formulary

Displaying 14671-14680 of 1611142 results.
ID: 14671
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 259306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14672
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799654
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14673
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 105292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14674
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053458
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14675
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199592
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 14676
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 805464
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 14677
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659927
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14678
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046585
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 14679
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 403878
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 14680
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098143
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0