CMS Formulary

Displaying 15641-15650 of 1611142 results.
ID: 15641
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110774
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 15642
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110777
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 15643
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110780
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 15644
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110783
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 15645
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110786
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 15646
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15647
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 866907
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15648
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000133
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15649
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801519
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 15650
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30