CMS Formulary

Displaying 17131-17140 of 1611142 results.
ID: 17131
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1869699
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17132
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805427
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17133
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602588
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17134
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805422
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17135
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602594
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17136
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858971
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17137
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 751620
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17138
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 751623
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17139
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 751616
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17140
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 827075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0