CMS Formulary

Displaying 15631-15640 of 1611142 results.
ID: 15631
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 308429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15632
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 283523
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2160
Qty Limit Days: 30
ID: 15633
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197745
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15634
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197746
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15635
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198358
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15636
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099569
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15637
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244214
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15638
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197312
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15639
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 15640
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0