CMS Formulary

Displaying 14841-14850 of 1611142 results.
ID: 14841
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 706829
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 14842
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 706825
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 14843
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 858074
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 14844
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 858051
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 14845
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 858057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 14846
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 858055
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 14847
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 858053
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 14848
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2059017
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14849
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1232084
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14850
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1232088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30