CMS Formulary

Displaying 13741-13750 of 1611142 results.
ID: 13741
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 856706
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13742
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 856429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13743
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 310670
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13744
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373483
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 7
ID: 13745
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373491
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13746
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 856797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13747
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 866491
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13748
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197963
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13749
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 856825
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13750
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313354
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0