CMS Formulary

Displaying 17171-17180 of 1611142 results.
ID: 17171
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198202
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17172
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 857677
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17173
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245443
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17174
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17175
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 309329
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17176
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 314078
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17177
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197635
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17178
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197634
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17179
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 238154
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 17180
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 309844
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30