CMS Formulary

Displaying 12971-12980 of 1611142 results.
ID: 12971
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 12972
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659161
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 12973
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12974
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467575
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12975
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2472789
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12976
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2478450
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 12977
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2369403
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 12978
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1594673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12979
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 905059
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 12980
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 905064
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84