CMS Formulary

Displaying 15121-15130 of 1611142 results.
ID: 15121
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15122
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15123
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551923
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15124
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601373
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15125
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15126
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15127
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 853356
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15128
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 848164
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15129
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15130
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482814
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0