CMS Formulary

Displaying 15451-15460 of 1611142 results.
ID: 15451
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 643019
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 15452
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 643022
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15453
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 866482
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15454
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 866479
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15455
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 349401
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15456
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 349405
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15457
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 205322
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15458
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 205323
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15459
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 403853
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15460
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 403854
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0