CMS Formulary

Displaying 15621-15630 of 1611142 results.
ID: 15621
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 995624
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15622
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2266506
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 15623
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 857336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15624
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 857321
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15625
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 857328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15626
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 857340
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15627
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 259081
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15628
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 835603
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 15629
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 283536
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15630
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199387
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30