CMS Formulary

Displaying 10751-10760 of 1611142 results.
ID: 10751
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 106303
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10752
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313450
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10753
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313451
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10754
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 308508
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10755
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 310149
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 4
ID: 10756
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10757
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 284254
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10758
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197900
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 10759
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 10760
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197902
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30