CMS Formulary

Displaying 15291-15300 of 1611142 results.
ID: 15291
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309337
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15292
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197388
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15293
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197980
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15294
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 544455
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15295
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 863599
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15296
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 995241
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15297
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309686
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15298
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312055
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 15299
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085745
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15300
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 992432
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0