CMS Formulary

Displaying 11381-11390 of 1611142 results.
ID: 11381
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085633
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11382
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11383
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 11384
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 543546
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11385
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085644
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11386
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1014314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11387
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085686
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11388
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 151030
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11389
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 977990
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11390
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 977978
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0