CMS Formulary

Displaying 15361-15370 of 1611142 results.
ID: 15361
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 731566
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15362
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 731568
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15363
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 731571
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15364
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 15365
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049227
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 15366
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049216
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 15367
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 854801
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15368
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15369
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15370
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000647
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0