CMS Formulary

Displaying 15401-15410 of 1611142 results.
ID: 15401
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809471
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15402
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15403
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243326
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15404
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243330
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15405
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243229
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15406
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 616148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15407
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 901614
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15408
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147337
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15409
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1306298
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15410
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551999
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30