CMS Formulary

Displaying 15131-15140 of 1611142 results.
ID: 15131
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653166
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15132
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100079
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15133
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918044
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15134
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928689
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15135
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2118741
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15136
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000019
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15137
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1994362
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15138
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442992
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15139
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000023
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15140
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000027
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28