CMS Formulary

Displaying 13881-13890 of 1611142 results.
ID: 13881
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602588
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13882
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805422
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13883
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602594
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13884
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858971
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13885
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 751620
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13886
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 751623
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13887
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 751616
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13888
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 827075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13889
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 833151
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13890
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 833139
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30