CMS Formulary

Displaying 13611-13620 of 1611142 results.
ID: 13611
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 896006
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 13612
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539893
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13613
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487528
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13614
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547660
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13615
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13616
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720606
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 13617
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648789
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13618
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1945048
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13619
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045382
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13620
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2109239
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0