CMS Formulary

Displaying 13481-13490 of 1611142 results.
ID: 13481
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 403879
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13482
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 476556
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13483
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197535
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 13484
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310295
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13485
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310297
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13486
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313992
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13487
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313993
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13488
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310293
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13489
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310294
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13490
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 314000
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0