CMS Formulary

Displaying 13771-13780 of 1611142 results.
ID: 13771
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 966249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13772
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 892251
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13773
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 892255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13774
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 966270
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13775
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 349477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13776
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198324
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13777
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198325
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13778
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 198323
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13779
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 855942
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13780
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313366
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0