CMS Formulary

Displaying 15161-15170 of 1611142 results.
ID: 15161
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653225
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15162
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2182340
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15163
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2392142
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15164
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 261105
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15165
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310531
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15166
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310535
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15167
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547231
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15168
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110618
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15169
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114074
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15170
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114096
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30