CMS Formulary

Displaying 10961-10970 of 1611142 results.
ID: 10961
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 10962
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 672571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 10963
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10964
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10965
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 10966
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 10967
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 10968
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 10969
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540356
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10970
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 992475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0