CMS Formulary

Displaying 15461-15470 of 1611142 results.
ID: 15461
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 403855
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15462
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 859981
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15463
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 859975
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15464
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 849389
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15465
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313407
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15466
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313408
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15467
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15468
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310878
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15469
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311982
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15470
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 104884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0