CMS Formulary

Displaying 17121-17130 of 1611142 results.
ID: 17121
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 311683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17122
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 727575
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17123
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17124
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040016
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17125
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653470
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17126
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086776
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17127
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086780
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17128
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086786
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17129
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307415
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17130
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307421
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30