CMS Formulary

Displaying 13701-13710 of 1611142 results.
ID: 13701
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 13702
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2387331
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 13703
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486981
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13704
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486977
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13705
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940498
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13706
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593831
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13707
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593833
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13708
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593835
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13709
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593775
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13710
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861045
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28