CMS Formulary

Displaying 11311-11320 of 1611142 results.
ID: 11311
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11312
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 11313
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 11314
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 11315
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11316
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11317
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312846
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11318
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 283858
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11319
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 562704
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11320
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312849
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0