CMS Formulary

Displaying 17181-17190 of 1611142 results.
ID: 17181
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17182
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17183
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17184
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17185
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 17186
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197516
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17187
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197517
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17188
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 996740
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 17189
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 311369
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 17190
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482908
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0