CMS Formulary

Displaying 15771-15780 of 1611142 results.
ID: 15771
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790317
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15772
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 727714
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15773
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 314230
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15774
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861646
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15775
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861650
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15776
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861654
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15777
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 30
ID: 15778
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 349591
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15779
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 349592
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15780
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 349593
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30