CMS Formulary

Displaying 13561-13570 of 1611142 results.
ID: 13561
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311033
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 13562
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311027
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 13563
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 213442
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 13564
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860172
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 28
ID: 13565
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 13566
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206099
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 13567
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049380
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 13568
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986354
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 13569
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986356
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 13570
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205454
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28