CMS Formulary

Displaying 15741-15750 of 1611142 results.
ID: 15741
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1800500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15742
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 992150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15743
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 724863
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15744
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 724859
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15745
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 724861
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15746
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 403818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15747
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 897021
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15748
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049264
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 15749
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1856424
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15750
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0