CMS Formulary

Displaying 15411-15420 of 1611142 results.
ID: 15411
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15412
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2203999
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15413
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 15414
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544471
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15415
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544475
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15416
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591949
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15417
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204104
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 15418
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204102
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15419
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721619
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15420
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747697
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0