CMS Formulary

Displaying 11391-11400 of 1611142 results.
ID: 11391
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 309289
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 11392
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 309291
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 19
Qty Limit Days: 30
ID: 11393
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 895487
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11394
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 895987
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11395
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 797274
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11396
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 310982
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 11397
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313189
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 11398
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11399
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313852
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11400
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30