CMS Formulary

Displaying 15651-15660 of 1611142 results.
ID: 15651
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 15652
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 15653
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 15654
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 11
Qty Limit Days: 28
ID: 15655
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596778
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15656
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 15657
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673278
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 15658
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673280
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 15659
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925264
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 56
ID: 15660
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049343
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 365