CMS Formulary

Displaying 13941-13950 of 1611142 results.
ID: 13941
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806191
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13942
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806193
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 13943
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 905369
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13944
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 311166
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13945
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 197832
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13946
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 349196
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 13947
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 349197
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 13948
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 905516
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13949
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 905495
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 13950
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 835913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0