CMS Formulary

Displaying 12021-12030 of 1611142 results.
ID: 12021
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048450
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12022
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020065
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 12023
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048445
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12024
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 855626
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12025
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 855194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12026
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607617
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12027
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 311345
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12028
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12029
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 351256
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12030
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 351257
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0