CMS Formulary

Displaying 11281-11290 of 1611142 results.
ID: 11281
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198238
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11282
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922720
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11283
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650143
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11284
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298910
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 11285
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298816
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 11286
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298906
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 11287
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 858613
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11288
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 858616
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11289
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 858747
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11290
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 891881
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30