CMS Formulary

Displaying 11371-11380 of 1611142 results.
ID: 11371
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 239189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11372
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665107
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11373
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 309072
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11374
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 863538
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11375
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11376
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 240209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11377
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 318202
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 11378
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 238600
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11379
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 310465
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 11380
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085640
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0