CMS Formulary

Displaying 14901-14910 of 1611142 results.
ID: 14901
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861495
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14902
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197407
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14903
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14904
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 238920
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14905
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861487
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14906
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992281
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14907
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 14908
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 14909
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 857366
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 170
Qty Limit Days: 30
ID: 14910
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0