CMS Formulary

Displaying 17251-17260 of 1611142 results.
ID: 17251
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 310190
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17252
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 310191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17253
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 261178
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17254
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17255
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 106303
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17256
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 313450
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17257
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 313451
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17258
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 308508
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17259
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 310149
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 4
ID: 17260
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0