CMS Formulary

Displaying 15821-15830 of 1611142 results.
ID: 15821
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15822
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311204
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15823
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 15824
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15825
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 205304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15826
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15827
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 409823
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15828
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 15829
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 892672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15830
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923822
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0