CMS Formulary

Displaying 17071-17080 of 1611142 results.
ID: 17071
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 759743
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17072
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17073
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17074
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 284191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17075
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 310169
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17076
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 861657
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17077
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 486148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17078
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 486152
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17079
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 486146
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17080
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 577057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30