CMS Formulary

Displaying 14691-14700 of 1611142 results.
ID: 14691
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307061
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14692
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115698
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 180
ID: 14693
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1308569
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14694
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 351209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14695
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197623
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14696
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055650
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 14697
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099808
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14698
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14699
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190919
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14700
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244205
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0