CMS Formulary

Displaying 15001-15010 of 1611142 results.
ID: 15001
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921598
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15002
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 828348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15003
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369831
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 15004
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870950
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15005
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870956
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15006
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870952
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15007
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870960
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15008
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870968
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 15009
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1304985
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15010
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1811182
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30