CMS Formulary

Displaying 13921-13930 of 1611142 results.
ID: 13921
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245443
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13922
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13923
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309329
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13924
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 314078
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13925
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197635
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13926
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197634
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13927
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 238154
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 13928
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 309844
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 13929
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13930
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0