CMS Formulary

Displaying 11791-11800 of 1611142 results.
ID: 11791
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313777
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11792
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313778
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11793
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 314214
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11794
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312835
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11795
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 314215
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11796
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 312836
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11797
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 311277
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11798
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099563
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11799
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 904932
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 11800
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 313758
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0