CMS Formulary

Displaying 15671-15680 of 1611142 results.
ID: 15671
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15672
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861743
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15673
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861748
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15674
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861753
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15675
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309076
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15676
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309078
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15677
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198352
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15678
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 200031
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15679
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 200033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15680
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 315223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30