CMS Formulary

Displaying 17221-17230 of 1611142 results.
ID: 17221
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 541878
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17222
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 541892
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17223
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 577961
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17224
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 541363
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17225
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 751868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17226
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 751871
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17227
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 751870
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17228
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 762007
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17229
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 751885
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17230
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 753481
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0