CMS Formulary

Displaying 13031-13040 of 1611142 results.
ID: 13031
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 582971
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13032
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 582976
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13033
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1435117
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 13034
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 351859
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 13035
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1731317
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 13036
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 643177
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13037
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 643173
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 13038
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 643175
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13039
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 799830
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13040
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1045408
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30