CMS Formulary

Displaying 13371-13380 of 1611142 results.
ID: 13371
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13372
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 207035
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13373
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 261101
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13374
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 847232
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 13375
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 285018
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 13376
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 855178
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13377
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 866094
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13378
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 866083
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13379
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 211817
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13380
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801283
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0