CMS Formulary

Displaying 13331-13340 of 1611142 results.
ID: 13331
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603369
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13332
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13333
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425110
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 13334
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425118
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13335
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 867506
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13336
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425230
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13337
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425228
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13338
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245003
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 13339
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 825425
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13340
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 825429
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30