CMS Formulary

Displaying 12391-12400 of 1611142 results.
ID: 12391
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110780
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 12392
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110783
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 12393
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110786
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 12394
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 12395
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 866907
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12396
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000133
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12397
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801519
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 12398
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 12399
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 12400
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28