CMS Formulary

Displaying 12171-12180 of 1611142 results.
ID: 12171
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288816
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 12172
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858267
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12173
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939335
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 12174
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12175
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 315183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12176
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 831226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12177
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 831255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12178
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 831309
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12179
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 831338
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12180
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 831196
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0