CMS Formulary

Displaying 12061-12070 of 1611142 results.
ID: 12061
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 199390
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12062
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197553
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12063
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 328160
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12064
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 310490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12065
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 310488
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 12066
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 993687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12067
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 993691
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12068
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 903887
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12069
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 903891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12070
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 903884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0