CMS Formulary

Displaying 15751-15760 of 1611142 results.
ID: 15751
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861375
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15752
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861370
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15753
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373745
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15754
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 485442
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15755
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 485465
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15756
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 352066
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15757
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 656660
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15758
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989085
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 15759
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442143
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15760
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729053
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30