CMS Formulary

Displaying 15961-15970 of 1611142 results.
ID: 15961
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649401
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15962
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054979
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 15963
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054983
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 15964
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055016
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 15965
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055014
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 15966
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197701
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15967
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 15968
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 15969
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 15970
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0