CMS Formulary

Displaying 11731-11740 of 1611142 results.
ID: 11731
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 246172
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11732
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11733
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313498
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11734
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313499
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11735
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313496
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11736
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111110
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 10
ID: 11737
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2279847
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 10
ID: 11738
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1001690
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11739
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2465556
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11740
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 905394
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0