CMS Formulary

Displaying 15221-15230 of 1611142 results.
ID: 15221
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369736
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 15222
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940376
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15223
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940372
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15224
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197501
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15225
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396770
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 15226
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396774
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 15227
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288433
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15228
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288412
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15229
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288431
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15230
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 727816
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28