CMS Formulary

Displaying 13721-13730 of 1611142 results.
ID: 13721
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090639
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13722
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 800438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13723
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 800444
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13724
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 801012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13725
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 801000
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13726
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 801021
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13727
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 801031
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13728
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 866924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13729
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197465
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 13730
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197466
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30