CMS Formulary

Displaying 13231-13240 of 1611142 results.
ID: 13231
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13232
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103175
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 13233
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103179
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13234
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 810075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13235
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 810079
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13236
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284108
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 13237
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057205
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13238
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057216
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13239
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057212
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13240
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057219
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0