CMS Formulary

Displaying 11621-11630 of 1611142 results.
ID: 11621
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11622
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11623
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11624
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11625
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198035
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11626
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198036
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11627
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193341
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11628
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193337
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11629
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193345
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11630
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193349
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30