CMS Formulary

Displaying 15391-15400 of 1611142 results.
ID: 15391
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198181
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15392
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 251322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15393
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 763457
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15394
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653792
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15395
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719766
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15396
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667666
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15397
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667670
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15398
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667674
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15399
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667678
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15400
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741747
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0