CMS Formulary

Displaying 11431-11440 of 1611142 results.
ID: 11431
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200180
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11432
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11433
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11434
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 725021
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11435
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 725023
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11436
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 311994
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 11437
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 311995
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 11438
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648759
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 11439
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307061
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11440
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115698
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 180