CMS Formulary

Displaying 14861-14870 of 1611142 results.
ID: 14861
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739782
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14862
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 795085
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14863
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 849599
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14864
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739770
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14865
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251914
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14866
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 722256
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14867
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251918
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14868
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 724142
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14869
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 724156
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 14870
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30