CMS Formulary

Displaying 13271-13280 of 1611142 results.
ID: 13271
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13272
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148502
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13273
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168540
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13274
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 207088
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13275
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049858
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 13276
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049862
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 13277
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1855527
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13278
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13279
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13280
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726846
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0