CMS Formulary

Displaying 13041-13050 of 1611142 results.
ID: 13041
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1045404
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13042
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364441
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13043
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364447
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13044
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1145932
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13045
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799230
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13046
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13047
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925257
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13048
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1598989
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13049
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601660
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13050
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0