CMS Formulary

Displaying 14681-14690 of 1611142 results.
ID: 14681
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200174
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14682
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200177
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14683
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200180
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14684
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14685
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14686
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 725021
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14687
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 725023
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14688
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311994
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 14689
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311995
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 14690
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648759
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30