CMS Formulary

Displaying 12721-12730 of 1611142 results.
ID: 12721
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198014
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12722
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 311753
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12723
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12724
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197892
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12725
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 151029
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12726
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 311265
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12727
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 311264
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12728
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 897649
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12729
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 349594
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12730
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 349595
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30