CMS Formulary

Displaying 15851-15860 of 1611142 results.
ID: 15851
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 30
ID: 15852
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 30
ID: 15853
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15854
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309048
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15855
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 105171
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15856
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 995599
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15857
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 995607
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15858
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 307650
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15859
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309097
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15860
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309098
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0