CMS Formulary

Displaying 12991-13000 of 1611142 results.
ID: 12991
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 403914
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12992
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12993
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12994
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922763
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12995
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12996
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 12997
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 12998
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 12999
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364494
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 13000
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30