CMS Formulary

Displaying 13321-13330 of 1611142 results.
ID: 13321
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310138
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 13322
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310144
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 13323
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310147
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 13324
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364114
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13325
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364118
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13326
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364122
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13327
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653243
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13328
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1599797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13329
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13330
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603365
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0