CMS Formulary

Displaying 13531-13540 of 1611142 results.
ID: 13531
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 995156
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 13532
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 308963
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13533
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 317173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13534
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 308964
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13535
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197604
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13536
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197606
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13537
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198089
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13538
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198083
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13539
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 314055
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13540
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655960
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0