CMS Formulary

Displaying 13521-13530 of 1611142 results.
ID: 13521
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 859835
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13522
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 905273
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13523
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13524
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 312036
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13525
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 856940
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2700
Qty Limit Days: 30
ID: 13526
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 834137
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13527
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 810002
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13528
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 809990
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13529
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 809994
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13530
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 809998
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30