CMS Formulary

Displaying 13891-13900 of 1611142 results.
ID: 13891
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 833143
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13892
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 833149
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13893
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 833146
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13894
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433250
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13895
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13896
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433229
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13897
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433235
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13898
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13899
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307309
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13900
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052609
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0