CMS Formulary

Displaying 13111-13120 of 1611142 results.
ID: 13111
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 762839
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13112
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 762843
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13113
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 762875
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13114
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 762849
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13115
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 762852
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13116
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 762859
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13117
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 762868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13118
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 762897
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13119
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1009341
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 13120
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595462
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0