CMS Formulary

Displaying 12901-12910 of 1611142 results.
ID: 12901
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12902
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197558
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12903
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197557
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12904
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 903843
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12905
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661799
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 12906
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946589
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 32
Qty Limit Days: 30
ID: 12907
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1421461
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12908
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044928
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12909
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044932
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 12910
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049884
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30