CMS Formulary

Displaying 11581-11590 of 1611142 results.
ID: 11581
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105645
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11582
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105653
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 11583
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180336
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 11584
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 615979
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 11585
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 207059
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 11586
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 211140
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 11587
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 706831
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 11588
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 706827
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 11589
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 706829
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 11590
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 706825
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28