CMS Formulary

Displaying 12821-12830 of 1611142 results.
ID: 12821
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 483448
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 12822
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 483446
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 12823
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12824
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795598
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12825
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1366192
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 12826
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796922
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12827
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744001
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12828
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744005
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12829
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744009
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12830
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243585
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0