CMS Formulary

Displaying 12421-12430 of 1611142 results.
ID: 12421
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 861748
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12422
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 861753
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12423
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 309076
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12424
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 309078
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12425
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198352
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12426
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 200031
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12427
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 200033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12428
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 315223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 12429
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313161
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 12430
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313160
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30