CMS Formulary

Displaying 13631-13640 of 1611142 results.
ID: 13631
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198228
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13632
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 852913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13633
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 993536
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13634
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 852877
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13635
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197979
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13636
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197978
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13637
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1246306
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13638
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1246290
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13639
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13640
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116639
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0