CMS Formulary

Displaying 13621-13630 of 1611142 results.
ID: 13621
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2170993
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 13622
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2173822
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 13623
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395775
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13624
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 249066
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13625
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 207840
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13626
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178081
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13627
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13628
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13629
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 995278
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13630
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 995253
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0