CMS Formulary

Displaying 13261-13270 of 1611142 results.
ID: 13261
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047602
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 13262
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047608
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 13263
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047614
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 13264
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047596
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 13265
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047623
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 13266
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463737
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 13267
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463733
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 13268
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13269
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168548
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13270
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30