CMS Formulary

Displaying 15601-15610 of 1611142 results.
ID: 15601
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15602
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15603
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 242680
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15604
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 205292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15605
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 205290
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15606
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 315134
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15607
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 866021
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15608
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992303
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15609
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 427163
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15610
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399892
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28