CMS Formulary

Displaying 11931-11940 of 1611142 results.
ID: 11931
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544388
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11932
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544390
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11933
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544394
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11934
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544396
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11935
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544398
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11936
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544402
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11937
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659818
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 11938
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659814
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 11939
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658325
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 11940
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658329
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30