CMS Formulary

Displaying 17061-17070 of 1611142 results.
ID: 17061
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 17062
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 199689
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17063
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 603208
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17064
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 603203
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17065
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 17066
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17067
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 751901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 17068
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 17069
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 749761
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 17070
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 748868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0