CMS Formulary

Displaying 12301-12310 of 1611142 results.
ID: 12301
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 581531
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12302
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371050
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 12303
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371054
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 12304
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371058
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 12305
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371062
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 12306
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371066
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 12307
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482513
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12308
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482517
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12309
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482523
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12310
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482527
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30