CMS Formulary

Displaying 13141-13150 of 1611142 results.
ID: 13141
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003757
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13142
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003767
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13143
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797880
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13144
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1113046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13145
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 863836
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13146
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 863841
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13147
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 863829
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13148
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373327
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13149
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 905164
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13150
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 688242
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0