CMS Formulary

Displaying 13121-13130 of 1611142 results.
ID: 13121
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595473
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13122
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595478
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13123
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13124
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1995479
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13125
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595457
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13126
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268231
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 13127
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268227
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 13128
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 402092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13129
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861637
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13130
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861206
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0