CMS Formulary

Displaying 13131-13140 of 1611142 results.
ID: 13131
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 904170
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13132
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 854859
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13133
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1859000
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13134
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604544
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 28
ID: 13135
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2002420
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 13136
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923338
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13137
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13138
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876406
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13139
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2375329
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13140
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0