CMS Formulary

Displaying 13191-13200 of 1611142 results.
ID: 13191
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197893
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13192
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313932
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13193
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309843
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 13194
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190568
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13195
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797907
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 13196
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197730
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13197
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13198
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 864761
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 13199
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 864769
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 13200
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 315187
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0