CMS Formulary

Displaying 13281-13290 of 1611142 results.
ID: 13281
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 847745
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 13282
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872980
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13283
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747577
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13284
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747579
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13285
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747567
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 13286
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747580
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13287
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921017
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13288
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921010
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13289
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921468
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13290
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 152971
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0