CMS Formulary

Displaying 13431-13440 of 1611142 results.
ID: 13431
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 13432
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13433
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 905032
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13434
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090996
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13435
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197595
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13436
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197596
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13437
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309958
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13438
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309960
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13439
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 884707
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 13440
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 753543
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0