CMS Formulary

Displaying 17081-17090 of 1611142 results.
ID: 17081
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437702
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 17082
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 857002
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 17083
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 857005
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 17084
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 856999
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 17085
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 993781
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 17086
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049221
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 17087
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049225
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 17088
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 17089
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 17090
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30