CMS Formulary

Displaying 13001-13010 of 1611142 results.
ID: 13001
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046597
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 228
Qty Limit Days: 14
ID: 13002
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989117
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 13003
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178792
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 13004
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 644304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13005
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 861659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13006
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 861661
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13007
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 861663
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13008
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 545278
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13009
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551300
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 13010
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551306
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28