CMS Formulary

Displaying 13391-13400 of 1611142 results.
ID: 13391
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197380
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13392
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198045
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13393
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 317136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13394
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13395
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198047
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13396
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312059
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13397
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 866018
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13398
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 603103
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13399
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 106346
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 220
Qty Limit Days: 30
ID: 13400
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098649
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0