CMS Formulary

Displaying 13871-13880 of 1611142 results.
ID: 13871
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13872
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040016
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13873
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653470
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13874
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086776
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13875
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086780
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13876
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086786
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13877
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307415
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13878
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307421
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13879
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1869699
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13880
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805427
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30