CMS Formulary

Displaying 15471-15480 of 1611142 results.
ID: 15471
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861430
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15472
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 886662
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15473
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 886666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15474
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 886671
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15475
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 686400
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15476
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190572
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15477
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 686418
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15478
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 835829
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15479
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 860975
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15480
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 860981
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30