CMS Formulary

Displaying 13081-13090 of 1611142 results.
ID: 13081
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486841
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13082
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 798300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13083
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 830253
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13084
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 830245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13085
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 836636
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13086
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 836634
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13087
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597099
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365
ID: 13088
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597103
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365
ID: 13089
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1292443
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13090
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 804186
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0