CMS Formulary

Displaying 13681-13690 of 1611142 results.
ID: 13681
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 801417
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13682
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 204520
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13683
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13684
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 800928
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13685
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 800812
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13686
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1189640
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13687
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 800933
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13688
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001321
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 13689
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091843
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13690
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 402091
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30