CMS Formulary

Displaying 12851-12860 of 1611142 results.
ID: 12851
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001439
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 12852
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12853
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918242
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 12854
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862595
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 12855
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921589
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 12856
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862590
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 12857
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666542
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12858
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 831246
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12859
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 849515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12860
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 833008
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0