CMS Formulary

Displaying 13841-13850 of 1611142 results.
ID: 13841
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 13842
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 13843
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 13844
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 864706
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13845
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049611
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13846
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049618
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13847
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 245136
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 13848
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 245134
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 13849
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 245135
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 13850
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197696
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30