CMS Formulary

Displaying 12191-12200 of 1611142 results.
ID: 12191
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 897584
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12192
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 897590
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12193
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 897596
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12194
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 317769
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12195
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 314208
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12196
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312847
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12197
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 205284
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12198
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 205285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12199
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 643019
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 12200
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 643022
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30