CMS Formulary

Displaying 17281-17290 of 1611142 results.
ID: 17281
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 897630
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17282
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 312025
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17283
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198041
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17284
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 582926
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17285
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597123
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 17286
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597129
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 17287
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 238134
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 17288
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745091
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 17289
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801289
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17290
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 311892
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0