CMS Formulary

Displaying 14871-14880 of 1611142 results.
ID: 14871
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739788
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 14872
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 14873
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14874
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14875
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14876
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14877
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198035
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14878
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198036
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14879
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193341
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 14880
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193337
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30