CMS Formulary

Displaying 15591-15600 of 1611142 results.
ID: 15591
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790890
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15592
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2384465
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 15593
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670324
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 28
ID: 15594
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 15595
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309952
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15596
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197622
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15597
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309955
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15598
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1117531
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 15599
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116758
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 30
ID: 15600
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440936
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0