CMS Formulary

Displaying 12261-12270 of 1611142 results.
ID: 12261
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 825334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12262
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 212118
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12263
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 542370
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12264
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988768
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12265
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921228
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 12266
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988772
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12267
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988786
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12268
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723763
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 12269
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723767
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 12270
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723772
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28