CMS Formulary

Displaying 17161-17170 of 1611142 results.
ID: 17161
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 106387
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17162
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 308714
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 17163
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 755497
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17164
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 992765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17165
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 17166
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 245314
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 17167
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 485968
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17168
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 991061
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17169
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 857683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17170
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0