CMS Formulary

Displaying 14751-14760 of 1611142 results.
ID: 14751
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197986
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14752
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 860215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14753
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 860221
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14754
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 349194
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 14755
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 349195
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 14756
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 349198
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 14757
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 403825
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14758
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312439
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14759
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198103
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14760
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 250820
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30