CMS Formulary

Displaying 12481-12490 of 1611142 results.
ID: 12481
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 722134
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12482
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 722137
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12483
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 722126
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12484
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 722131
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12485
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 860715
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12486
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 860695
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12487
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 860707
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12488
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1800499
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12489
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1800500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12490
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 992150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0