CMS Formulary

Displaying 14711-14720 of 1611142 results.
ID: 14711
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 763106
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14712
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658241
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14713
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939299
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 14714
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939348
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 14715
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 577324
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14716
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 727316
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 14717
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870207
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 14718
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1374574
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 14719
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14720
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2198370
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30