CMS Formulary

Displaying 11171-11180 of 1611142 results.
ID: 11171
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659287
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11172
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 242800
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11173
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721315
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11174
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11175
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11176
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 616539
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11177
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 616541
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11178
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11179
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11180
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0