CMS Formulary

Displaying 13971-13980 of 1611142 results.
ID: 13971
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 577961
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13972
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 541363
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 13973
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 751868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13974
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 751871
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13975
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 751870
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13976
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 762007
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13977
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 751885
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13978
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 753481
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13979
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 762333
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 13980
Formulary ID: 00021004
Formulary Version: 14
Contract Year: 2021
RXCUI: 751890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0