CMS Formulary

Displaying 13471-13480 of 1611142 results.
ID: 13471
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 349094
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13472
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 351109
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13473
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13474
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098678
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13475
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 904467
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13476
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 904475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13477
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490065
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13478
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199058
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13479
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 596843
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13480
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 308868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0