CMS Formulary

Displaying 13251-13260 of 1611142 results.
ID: 13251
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 616283
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13252
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284106
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 13253
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 616287
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13254
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1541928
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13255
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 616292
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13256
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1357547
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13257
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048568
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13258
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2478437
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13259
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099956
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13260
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30