CMS Formulary

Displaying 13381-13390 of 1611142 results.
ID: 13381
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 978006
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13382
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 834022
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 13383
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 833217
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13384
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 831103
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13385
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 831102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13386
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 831054
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13387
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197724
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13388
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197381
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13389
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13390
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 904458
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0