CMS Formulary

Displaying 11401-11410 of 1611142 results.
ID: 11401
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11402
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 11403
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 11404
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 855168
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11405
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11406
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 11407
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11408
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11409
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11410
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0