CMS Formulary

Displaying 13351-13360 of 1611142 results.
ID: 13351
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1365866
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13352
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656351
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13353
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873991
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 13354
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873993
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 28
ID: 13355
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873995
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 13356
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1421456
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13357
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923054
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 49
Qty Limit Days: 28
ID: 13358
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801840
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13359
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923056
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 70
Qty Limit Days: 28
ID: 13360
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923058
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28