CMS Formulary

Displaying 13711-13720 of 1611142 results.
ID: 13711
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 861043
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 13712
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13713
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 801357
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13714
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 801112
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13715
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 801136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13716
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799706
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13717
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 805131
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13718
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 801648
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13719
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 800420
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13720
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 800405
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0