CMS Formulary

Displaying 11191-11200 of 1611142 results.
ID: 11191
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 854901
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11192
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313762
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11193
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313761
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11194
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 884173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11195
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 884185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11196
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 884189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11197
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099625
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11198
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 996571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11199
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 996561
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11200
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 854916
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0