CMS Formulary

Displaying 15491-15500 of 1611142 results.
ID: 15491
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099678
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15492
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099870
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15493
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356563
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15494
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356572
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15495
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356576
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15496
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356580
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15497
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356584
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15498
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356588
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15499
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790126
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 720
Qty Limit Days: 30
ID: 15500
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 824299
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0