CMS Formulary

Displaying 10561-10570 of 1611142 results.
ID: 10561
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 10562
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10563
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 751901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 10564
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 10565
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 749761
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 10566
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 748868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10567
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 759743
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10568
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10569
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10570
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 284191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0