CMS Formulary

Displaying 15311-15320 of 1611142 results.
ID: 15311
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197627
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15312
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197628
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15313
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199390
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15314
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197553
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15315
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 328160
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15316
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15317
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310488
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15318
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 993687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15319
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 993691
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15320
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 903887
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0