CMS Formulary

Displaying 15421-15430 of 1611142 results.
ID: 15421
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741739
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15422
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799218
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15423
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288816
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15424
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858267
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15425
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939335
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 15426
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15427
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 315183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15428
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 831226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15429
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 831255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15430
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 831309
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0