CMS Formulary

Displaying 13021-13030 of 1611142 results.
ID: 13021
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946836
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 13022
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2256943
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 13023
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205474
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13024
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946840
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 13025
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946844
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 13026
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946848
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 13027
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 207834
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13028
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1718936
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 13029
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13030
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 729234
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0