CMS Formulary

Displaying 12791-12800 of 1611142 results.
ID: 12791
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602040
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 12792
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602046
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 12793
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265729
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12794
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265732
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12795
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265735
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12796
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809643
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12797
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809499
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12798
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1495070
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 12799
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 199888
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12800
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 151226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0