CMS Formulary

Displaying 12161-12170 of 1611142 results.
ID: 12161
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 12162
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544471
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12163
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544475
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12164
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591949
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 12165
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204104
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 12166
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204102
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 12167
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721619
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12168
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747697
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12169
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741739
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12170
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799218
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28