CMS Formulary

Displaying 10801-10810 of 1611142 results.
ID: 10801
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197363
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10802
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10803
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197383
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10804
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197382
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10805
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 805515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10806
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 603378
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10807
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190225
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 10808
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 580261
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 10809
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 836368
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 28
ID: 10810
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1552004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30