CMS Formulary

Displaying 11571-11580 of 1611142 results.
ID: 11571
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 391937
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11572
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 197305
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11573
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 212787
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11574
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1312408
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 11575
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439894
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 11576
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439896
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 11577
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439899
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 11578
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 11579
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439903
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 11580
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105657
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30