CMS Formulary

Displaying 14741-14750 of 1611142 results.
ID: 14741
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 835593
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14742
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 835564
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14743
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 835568
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14744
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197739
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14745
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14746
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14747
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14748
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14749
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14750
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0