CMS Formulary

Displaying 12241-12250 of 1611142 results.
ID: 12241
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356563
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12242
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356572
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12243
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356576
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12244
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356580
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12245
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356584
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12246
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356588
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12247
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790126
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 720
Qty Limit Days: 30
ID: 12248
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 824299
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12249
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 824303
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12250
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054157
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0