CMS Formulary

Displaying 12751-12760 of 1611142 results.
ID: 12751
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 835726
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12752
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 349373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12753
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 857216
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12754
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 857224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12755
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 314266
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 12756
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 749784
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12757
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 644088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 12758
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603861
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 12759
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12760
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0