CMS Formulary

Displaying 11561-11570 of 1611142 results.
ID: 11561
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100099
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 11562
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100100
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 11563
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312614
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11564
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 283077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11565
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 993755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4500
Qty Limit Days: 30
ID: 11566
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197448
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11567
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923432
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11568
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 477391
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11569
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197877
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11570
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010739
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0