CMS Formulary

Displaying 12861-12870 of 1611142 results.
ID: 12861
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 883826
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12862
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197943
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12863
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197944
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12864
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659929
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12865
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102705
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12866
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058906
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12867
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872458
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 12868
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049133
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 12869
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049121
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 12870
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1855072
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30