CMS Formulary

Displaying 11251-11260 of 1611142 results.
ID: 11251
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 905041
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11252
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 11253
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 11254
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11255
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11256
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11257
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11258
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11259
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 809871
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 11260
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 864661
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0