CMS Formulary

Displaying 15801-15810 of 1611142 results.
ID: 15801
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737581
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15802
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048025
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15803
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 404419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15804
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 106351
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15805
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15806
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198242
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 15807
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 308136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15808
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15809
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310432
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 15810
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311880
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0