CMS Formulary

Displaying 13671-13680 of 1611142 results.
ID: 13671
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197541
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13672
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 753478
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13673
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 753479
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13674
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13675
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091828
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13676
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13677
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 351174
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13678
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 351175
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13679
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 794639
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13680
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 616578
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30