CMS Formulary

Displaying 12651-12660 of 1611142 results.
ID: 12651
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729516
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12652
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1485332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12653
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1543553
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12654
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1422081
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12655
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1427300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12656
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 748800
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12657
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1599949
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 12658
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 848180
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12659
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123072
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 17
Qty Limit Days: 30
ID: 12660
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 314076
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0