CMS Formulary

Displaying 12141-12150 of 1611142 results.
ID: 12141
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 763457
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12142
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653792
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12143
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719766
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12144
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667666
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12145
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667670
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12146
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667674
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12147
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667678
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12148
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741747
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12149
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809471
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12150
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0