CMS Formulary

Displaying 12091-12100 of 1611142 results.
ID: 12091
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 205328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12092
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 314155
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12093
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 351107
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12094
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 859193
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12095
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 686379
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12096
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 855818
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12097
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12098
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665050
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12099
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665093
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12100
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665088
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0