CMS Formulary

Displaying 12271-12280 of 1611142 results.
ID: 12271
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726639
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12272
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364362
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12273
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364358
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12274
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2473042
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12275
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049271
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12276
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049278
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12277
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12278
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 284215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12279
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 544840
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12280
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313165
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28