CMS Formulary

Displaying 12001-12010 of 1611142 results.
ID: 12001
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 401953
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12002
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12003
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 616698
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 12004
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 616705
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 12005
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312635
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12006
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198365
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12007
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 995666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12008
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198145
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12009
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12010
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313217
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0