CMS Formulary

Displaying 13781-13790 of 1611142 results.
ID: 13781
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000070
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13782
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536586
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 13783
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 242333
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 13784
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 241527
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 13785
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 403922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 13786
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 402109
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13787
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 834235
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13788
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 834241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13789
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 359144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13790
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 359145
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0