CMS Formulary

Displaying 17311-17320 of 1611142 results.
ID: 17311
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190225
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 17312
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 580261
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17313
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 836368
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 28
ID: 17314
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1552004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 17315
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723478
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17316
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430453
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17317
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430457
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17318
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100706
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17319
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430449
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17320
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1592748
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30