CMS Formulary

Displaying 15201-15210 of 1611142 results.
ID: 15201
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044355
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15202
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044357
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15203
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044969
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 15204
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044967
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 15205
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044971
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 15206
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649961
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 15207
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1550946
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15208
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 213360
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15209
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 404449
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15210
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 700418
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30