CMS Formulary

Displaying 11741-11750 of 1611142 results.
ID: 11741
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11742
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1543069
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 11743
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11744
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11745
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11746
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 310152
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 11747
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180999
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11748
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1716268
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11749
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921598
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11750
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 828348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0