CMS Formulary

Displaying 11151-11160 of 1611142 results.
ID: 11151
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 314165
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11152
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 226343
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11153
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11154
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 308493
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11155
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11156
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 310594
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11157
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 905379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11158
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11159
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791560
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11160
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791569
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30