CMS Formulary

Displaying 14851-14860 of 1611142 results.
ID: 14851
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114202
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14852
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14853
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650968
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 84
ID: 14854
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650972
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 14855
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650974
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 14856
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650976
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 84
ID: 14857
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739766
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14858
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739774
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14859
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2173500
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 14860
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739778
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30