CMS Formulary

Displaying 13181-13190 of 1611142 results.
ID: 13181
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 897657
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 13182
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049604
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1300
Qty Limit Days: 30
ID: 13183
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874559
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13184
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874553
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13185
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 900575
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13186
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 977427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13187
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 977434
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13188
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 977438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13189
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 892625
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 13190
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311355
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0