CMS Formulary

Displaying 15251-15260 of 1611142 results.
ID: 15251
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 259966
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15252
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197973
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15253
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 401953
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15254
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15255
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 616698
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15256
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 616705
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15257
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312635
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15258
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198365
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15259
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 995666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15260
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198145
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0