CMS Formulary

Displaying 13301-13310 of 1611142 results.
ID: 13301
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115459
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13302
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115464
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13303
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115473
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13304
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946522
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13305
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 727705
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13306
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655728
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13307
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 825170
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13308
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801278
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13309
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 847741
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13310
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 835892
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0