CMS Formulary

Displaying 10501-10510 of 1611142 results.
ID: 10501
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198270
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10502
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197960
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10503
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10504
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 856422
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10505
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 199903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10506
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 998671
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 10507
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 998675
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 10508
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 998679
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 10509
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000048
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10510
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312593
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0