CMS Formulary

Displaying 14821-14830 of 1611142 results.
ID: 14821
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197877
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14822
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010739
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14823
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 391937
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14824
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197305
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14825
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 212787
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14826
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1312408
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 14827
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439894
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 14828
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439896
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 14829
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439899
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 14830
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30