CMS Formulary

Displaying 11921-11930 of 1611142 results.
ID: 11921
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049504
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11922
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049545
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11923
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049565
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11924
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049576
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11925
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049586
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11926
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049595
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11927
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049601
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 11928
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544404
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11929
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544383
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11930
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544386
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0