CMS Formulary

Displaying 11751-11760 of 1611142 results.
ID: 11751
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369831
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 11752
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870950
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11753
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870956
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11754
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870952
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11755
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870960
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11756
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870968
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 11757
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1304985
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 11758
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1811182
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 11759
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649405
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11760
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313096
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0