CMS Formulary

Displaying 12291-12300 of 1611142 results.
ID: 12291
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312069
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12292
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312070
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12293
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1117522
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12294
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664981
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12295
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 859871
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12296
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 204416
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12297
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722934
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12298
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807632
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12299
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795609
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12300
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0