CMS Formulary

Displaying 15021-15030 of 1611142 results.
ID: 15021
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099691
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 15022
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099697
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 15023
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313785
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15024
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 207588
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15025
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 213510
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15026
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310386
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15027
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15028
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311787
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15029
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605088
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15030
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0