CMS Formulary

Displaying 15611-15620 of 1611142 results.
ID: 15611
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399895
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 15612
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399898
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 15613
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 15614
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15615
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15616
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797113
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 15617
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399904
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 15618
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098141
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15619
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098134
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15620
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 577033
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30