CMS Formulary

Displaying 17141-17150 of 1611142 results.
ID: 17141
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 833151
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17142
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 833139
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17143
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 833143
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17144
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 833149
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17145
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 833146
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17146
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433250
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17147
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17148
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433229
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17149
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433235
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17150
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30