CMS Formulary

Displaying 17001-17010 of 1611142 results.
ID: 17001
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 856825
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17002
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 313354
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17003
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198274
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17004
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198275
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17005
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198270
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17006
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197960
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17007
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17008
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 856422
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17009
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 199903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17010
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 998671
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28