CMS Formulary

Displaying 13571-13580 of 1611142 results.
ID: 13571
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653198
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 13572
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 977842
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 13573
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 977840
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 13574
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 897126
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 13575
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2398842
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 13576
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991311
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 13577
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991317
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 13578
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200654
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13579
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200658
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13580
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200650
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30