CMS Formulary

Displaying 12431-12440 of 1611142 results.
ID: 12431
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 854873
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12432
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198052
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12433
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312086
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12434
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 310384
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12435
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 310385
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12436
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313989
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12437
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 979485
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12438
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 979492
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12439
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 979480
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12440
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 248109
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0