CMS Formulary

Displaying 12561-12570 of 1611142 results.
ID: 12561
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 616483
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 12562
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312743
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 12563
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312840
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 12564
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 314209
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 12565
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 199206
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12566
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12567
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197806
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12568
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197807
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12569
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 311347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12570
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 311204
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0