CMS Formulary

Displaying 15321-15330 of 1611142 results.
ID: 15321
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 903891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15322
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 903884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15323
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 242446
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15324
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 857700
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 15325
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 213291
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15326
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111339
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15327
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 860805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15328
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111343
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15329
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 284008
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 15330
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313919
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28