CMS Formulary

Displaying 12371-12380 of 1611142 results.
ID: 12371
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 857336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12372
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 857321
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12373
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 857328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12374
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 857340
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12375
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 259081
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12376
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 835603
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 12377
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 283536
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12378
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 199387
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 12379
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 308429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12380
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 283523
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2160
Qty Limit Days: 30