CMS Formulary

Displaying 15231-15240 of 1611142 results.
ID: 15231
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 15232
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054995
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 7
ID: 15233
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123137
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 15234
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123141
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 15235
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123145
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15236
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1102277
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15237
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 794610
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15238
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 831870
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15239
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 850457
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15240
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1236632
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0