CMS Formulary

Displaying 12381-12390 of 1611142 results.
ID: 12381
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197745
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12382
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197746
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12383
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198358
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12384
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099569
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12385
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244214
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12386
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197312
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12387
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 12388
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12389
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110774
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 12390
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110777
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28