CMS Formulary

Displaying 15051-15060 of 1611142 results.
ID: 15051
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 904932
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 15052
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313758
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15053
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199655
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15054
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 349208
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15055
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 360110
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15056
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 206913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15057
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15058
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657151
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 15059
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 749206
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15060
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659592
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0