CMS Formulary

Displaying 12491-12500 of 1611142 results.
ID: 12491
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 724863
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12492
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 724859
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12493
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 724861
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12494
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 403818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12495
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 897021
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12496
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049264
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 12497
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1856424
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12498
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12499
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 861375
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12500
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 861370
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0