CMS Formulary

Displaying 12771-12780 of 1611142 results.
ID: 12771
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12772
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 562806
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 12773
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 825130
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12774
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 12775
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12776
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12777
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 801961
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12778
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 801966
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12779
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 245723
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12780
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 830861
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0