CMS Formulary

Displaying 17201-17210 of 1611142 results.
ID: 17201
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 905495
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 17202
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 835913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17203
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000405
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17204
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 995232
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17205
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 977883
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17206
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197863
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17207
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197556
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17208
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197554
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17209
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197555
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17210
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 856369
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0