CMS Formulary

Displaying 13601-13610 of 1611142 results.
ID: 13601
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 213484
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13602
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 759473
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 180
ID: 13603
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 896185
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13604
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 896212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13605
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 896229
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13606
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 896237
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 13607
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 896245
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 13608
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 896273
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 13609
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 895996
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 13610
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 896001
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28