CMS Formulary

Displaying 15211-15220 of 1611142 results.
ID: 15211
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 404450
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15212
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242233
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15213
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 616116
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15214
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 616114
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15215
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 643714
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15216
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1429367
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15217
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15218
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369724
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 15219
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369728
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 15220
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369732
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28