CMS Formulary

Displaying 11611-11620 of 1611142 results.
ID: 11611
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 849599
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11612
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739770
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11613
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251914
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11614
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 722256
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11615
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251918
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11616
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 724142
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11617
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 724156
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11618
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11619
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739788
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 11620
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30