CMS Formulary

Displaying 15091-15100 of 1611142 results.
ID: 15091
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991509
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15092
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1865962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15093
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197699
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15094
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197700
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15095
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 596926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15096
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 596930
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15097
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 596934
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15098
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 308192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15099
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 834061
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15100
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 834102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0