CMS Formulary

Displaying 13581-13590 of 1611142 results.
ID: 13581
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653204
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 13582
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 351926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 13583
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 849851
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13584
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 847247
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13585
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 847348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13586
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 847245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13587
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197590
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13588
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197591
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13589
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197589
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13590
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197391
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0