CMS Formulary

Displaying 13011-13020 of 1611142 results.
ID: 13011
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058877
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 13012
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745108
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13013
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395779
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 13014
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058887
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 13015
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2370174
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13016
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2170613
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 30
ID: 13017
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395785
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 13018
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2370170
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 13019
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047247
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13020
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2256947
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30