CMS Formulary

Displaying 12441-12450 of 1611142 results.
ID: 12441
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 314108
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12442
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 311290
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12443
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 854984
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12444
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 854988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12445
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 854925
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12446
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 904431
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 12447
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312087
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12448
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12449
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198335
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12450
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 979468
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0