CMS Formulary

Displaying 11971-11980 of 1611142 results.
ID: 11971
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940372
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11972
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197501
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 11973
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396770
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 11974
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396774
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 11975
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288433
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11976
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288412
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 11977
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288431
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 11978
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 727816
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 11979
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 11980
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054995
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 7