CMS Formulary

Displaying 13641-13650 of 1611142 results.
ID: 13641
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872261
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13642
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055008
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13643
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 991233
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13644
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 308047
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13645
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 308048
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13646
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197321
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13647
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197322
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 13648
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13649
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197444
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13650
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197445
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0