CMS Formulary

Displaying 11261-11270 of 1611142 results.
ID: 11261
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001424
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11262
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363408
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 11263
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363410
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 11264
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364581
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 11265
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790175
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11266
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790167
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11267
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11268
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928941
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 11269
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11270
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0