CMS Formulary

Displaying 15271-15280 of 1611142 results.
ID: 15271
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313142
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15272
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15273
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048450
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15274
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020065
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 15275
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048445
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15276
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 855626
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15277
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 855194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15278
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607617
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15279
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311345
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15280
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0