CMS Formulary

Displaying 13061-13070 of 1611142 results.
ID: 13061
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13062
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13063
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13064
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13065
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13066
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13067
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13068
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547114
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13069
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547118
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13070
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235595
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0