CMS Formulary

Displaying 12521-12530 of 1611142 results.
ID: 12521
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 314230
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12522
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 861646
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12523
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 861650
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12524
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 861654
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12525
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 30
ID: 12526
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 349591
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12527
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 349592
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12528
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 349593
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12529
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011736
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12530
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011739
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0