CMS Formulary

Displaying 11871-11880 of 1611142 results.
ID: 11871
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551923
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11872
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601373
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11873
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11874
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11875
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 853356
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11876
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 848164
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11877
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11878
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482814
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11879
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653166
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11880
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100079
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30