CMS Formulary

Displaying 10671-10680 of 1611142 results.
ID: 10671
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 309329
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10672
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 314078
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10673
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197635
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 10674
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197634
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 10675
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 238154
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 10676
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 309844
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 10677
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10678
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10679
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10680
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0