CMS Formulary

Displaying 14891-14900 of 1611142 results.
ID: 14891
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606866
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 14892
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2257013
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 14893
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606870
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 14894
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053519
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 14895
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2166401
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 14896
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999389
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 14897
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812470
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 14898
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655934
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 14899
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053512
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 14900
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 904158
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0