CMS Formulary

Displaying 15101-15110 of 1611142 results.
ID: 15101
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310436
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15102
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310437
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15103
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 579148
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15104
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 104894
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15105
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861132
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15106
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310352
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15107
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15108
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15109
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15110
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30