CMS Formulary

Displaying 12691-12700 of 1611142 results.
ID: 12691
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 861736
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 12692
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 861740
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 12693
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312817
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12694
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 577315
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12695
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12696
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 836395
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 12697
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 833234
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12698
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12699
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12700
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0