CMS Formulary

Displaying 15511-15520 of 1611142 results.
ID: 15511
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 825333
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15512
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 825325
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15513
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 825334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15514
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 212118
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15515
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 542370
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15516
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988768
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15517
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921228
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15518
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988772
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15519
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988786
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15520
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723763
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28