CMS Formulary

Displaying 17261-17270 of 1611142 results.
ID: 17261
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 284254
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17262
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197900
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 17263
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 17264
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197902
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 17265
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 311386
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17266
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 311385
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17267
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 314075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17268
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 310812
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17269
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 861427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17270
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 991086
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0