CMS Formulary

Displaying 13691-13700 of 1611142 results.
ID: 13691
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986819
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13692
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2289424
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 13693
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2289428
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13694
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942485
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13695
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13696
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 13697
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 13698
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13699
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13700
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28