CMS Formulary

Displaying 15781-15790 of 1611142 results.
ID: 15781
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011736
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15782
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011739
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15783
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 388311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15784
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 200133
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15785
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 200131
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15786
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861237
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15787
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861221
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15788
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15789
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 15790
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30