CMS Formulary

Displaying 14801-14810 of 1611142 results.
ID: 14801
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 205532
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14802
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1592285
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 14803
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1868016
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 14804
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1868020
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 14805
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1727485
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 14806
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1441530
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14807
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242998
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14808
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2106075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14809
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2390946
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14810
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058950
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0