CMS Formulary

Displaying 13441-13450 of 1611142 results.
ID: 13441
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110455
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13442
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1314763
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13443
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312594
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13444
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198141
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13445
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 834046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13446
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 834040
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13447
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197536
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 13448
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 429212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 13449
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309374
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 135
Qty Limit Days: 30
ID: 13450
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0