CMS Formulary

Displaying 13661-13670 of 1611142 results.
ID: 13661
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 993466
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13662
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 993470
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13663
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 993462
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13664
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047868
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 13665
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 834350
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13666
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801299
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13667
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 832731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13668
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801295
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13669
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 13670
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0