CMS Formulary

Displaying 12981-12990 of 1611142 results.
ID: 12981
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 905057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 168
ID: 12982
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12983
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 12984
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1368459
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12985
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 751970
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12986
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 836358
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 312
Qty Limit Days: 30
ID: 12987
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191250
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12988
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 207373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12989
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245268
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 12990
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 314088
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0