CMS Formulary

Displaying 11721-11730 of 1611142 results.
ID: 11721
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091341
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 11722
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359124
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11723
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 403884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11724
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 310599
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11725
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 856535
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11726
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 856569
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11727
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 856460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11728
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 856481
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11729
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 860654
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11730
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 199450
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30