CMS Formulary

Displaying 12811-12820 of 1611142 results.
ID: 12811
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373497
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12812
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 403875
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12813
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 310430
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 12814
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 310459
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12815
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 828320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12816
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 314285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12817
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 200311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12818
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 310431
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 12819
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 728113
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 180
ID: 12820
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 483442
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30