CMS Formulary

Displaying 11761-11770 of 1611142 results.
ID: 11761
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 318179
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11762
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 283535
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11763
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11764
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 198150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11765
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 96304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11766
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 998689
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11767
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 998685
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11768
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099686
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 11769
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099691
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 11770
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099697
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28