CMS Formulary

Displaying 12781-12790 of 1611142 results.
ID: 12781
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 830845
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12782
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 830837
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12783
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 830801
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12784
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 352257
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 12785
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2393794
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 12786
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121764
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12787
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2173841
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12788
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12789
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602028
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 12790
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602034
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28