CMS Formulary

Displaying 12711-12720 of 1611142 results.
ID: 12711
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054983
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 12712
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055016
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 12713
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055014
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 12714
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197701
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12715
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 12716
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 12717
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12718
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12719
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358776
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12720
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 309367
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0