CMS Formulary

Displaying 13931-13940 of 1611142 results.
ID: 13931
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13932
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13933
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 13934
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197516
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13935
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197517
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13936
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 996740
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 13937
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311369
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 13938
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482908
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13939
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806187
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13940
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806189
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30