CMS Formulary

Displaying 12361-12370 of 1611142 results.
ID: 12361
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 12362
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12363
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12364
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797113
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 12365
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399904
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 12366
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098141
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12367
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098134
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12368
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 577033
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 12369
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 995624
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12370
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2266506
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28