CMS Formulary

Displaying 13801-13810 of 1611142 results.
ID: 13801
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 260351
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13802
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13803
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13804
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 13805
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13806
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111641
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13807
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 13808
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 13809
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 13810
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 199689
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0