CMS Formulary

Displaying 10971-10980 of 1611142 results.
ID: 10971
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 995258
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10972
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297753
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10973
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297757
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10974
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049621
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 10975
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2101899
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 10976
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049683
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 10977
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049686
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 10978
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091150
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 10979
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 899557
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 10980
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 899518
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30