CMS Formulary

Displaying 13101-13110 of 1611142 results.
ID: 13101
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 404457
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13102
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 404458
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13103
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 404459
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13104
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549456
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13105
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549454
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13106
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 205562
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13107
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 763489
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13108
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 996559
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13109
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 762833
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13110
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 762836
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0