CMS Formulary

Displaying 15141-15150 of 1611142 results.
ID: 15141
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000031
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15142
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300386
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15143
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 829989
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15144
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 830552
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15145
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 830557
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15146
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 803371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15147
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300810
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15148
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 798430
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15149
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 798428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15150
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986830
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 365