CMS Formulary

Displaying 15241-15250 of 1611142 results.
ID: 15241
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359271
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15242
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 758555
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15243
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1052660
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15244
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1250723
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15245
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1600710
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15246
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999587
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15247
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15248
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2373941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15249
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049677
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15250
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 762675
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0