CMS Formulary

Displaying 15331-15340 of 1611142 results.
ID: 15331
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797865
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 34
Qty Limit Days: 28
ID: 15332
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797867
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 25
ID: 15333
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 860107
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 25
ID: 15334
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 904481
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15335
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 617312
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15336
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 617310
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15337
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 617311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15338
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15339
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 259255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15340
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 905028
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28