CMS Formulary

Displaying 12461-12470 of 1611142 results.
ID: 12461
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12462
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12463
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12464
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12465
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 349483
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12466
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 349199
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12467
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 349200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12468
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 200224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12469
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 898350
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12470
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 898353
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0