CMS Formulary

Displaying 11501-11510 of 1611142 results.
ID: 11501
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 860221
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11502
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 349194
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 11503
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 349195
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 11504
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 349198
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 11505
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 403825
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11506
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312439
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11507
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198103
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11508
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 250820
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 11509
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 858751
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11510
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 858733
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0