CMS Formulary

Displaying 13651-13660 of 1611142 results.
ID: 13651
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197816
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13652
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197815
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13653
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1001004
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13654
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 351264
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 13655
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 904605
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13656
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 904571
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13657
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 904583
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13658
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 904593
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13659
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 848951
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13660
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 834346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0