CMS Formulary

Displaying 11591-11600 of 1611142 results.
ID: 11591
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 858074
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 11592
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 858051
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 11593
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 858057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 11594
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 858055
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 11595
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 858053
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 11596
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2059017
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11597
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1232084
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11598
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1232088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11599
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114202
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11600
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0