CMS Formulary

Displaying 11301-11310 of 1611142 results.
ID: 11301
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11302
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11303
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1491624
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11304
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468316
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 11305
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2381144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11306
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 465355
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11307
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 979099
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11308
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 967023
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11309
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 967012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11310
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0