CMS Formulary

Displaying 14721-14730 of 1611142 results.
ID: 14721
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 865208
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14722
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 865212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14723
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 865216
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14724
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 723827
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14725
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 729201
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14726
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 729203
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14727
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796079
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14728
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796083
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14729
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433879
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14730
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546894
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0