CMS Formulary

Displaying 11341-11350 of 1611142 results.
ID: 11341
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198040
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11342
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010600
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11343
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11344
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11345
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11346
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 351223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 11347
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198070
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11348
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 401938
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 11349
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 751566
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11350
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 751568
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0