CMS Formulary

Displaying 10701-10710 of 1611142 results.
ID: 10701
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 977883
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10702
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197863
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10703
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197556
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10704
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197554
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10705
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197555
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10706
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 856369
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10707
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1009145
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 10708
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 687043
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 10709
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 577957
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 10710
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0