CMS Formulary

Displaying 12931-12940 of 1611142 results.
ID: 12931
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2275613
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12932
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272118
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12933
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272122
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12934
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272126
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12935
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2394947
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 12936
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12937
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199308
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12938
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199312
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12939
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12940
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 206883
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0