CMS Formulary

Displaying 12891-12900 of 1611142 results.
ID: 12891
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197698
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12892
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 856783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12893
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607796
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12894
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607792
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12895
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992873
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 12896
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2119706
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 12897
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 349287
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12898
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1927682
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 14
ID: 12899
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12900
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0