CMS Formulary

Displaying 12581-12590 of 1611142 results.
ID: 12581
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490026
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 12582
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490034
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 12583
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490038
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 12584
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313580
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12585
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2257015
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12586
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044720
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12587
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044726
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12588
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044732
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12589
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046376
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12590
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046380
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0