CMS Formulary

Displaying 11161-11170 of 1611142 results.
ID: 11161
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 11162
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791582
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 11163
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812015
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11164
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 862006
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11165
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 862013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11166
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 862019
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11167
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 862025
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11168
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11169
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737578
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11170
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659283
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0