CMS Formulary

Displaying 17321-17330 of 1611142 results.
ID: 17321
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1592752
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17322
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243033
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17323
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243040
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17324
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243026
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17325
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1545664
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17326
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1545668
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17327
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1651275
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 17328
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664321
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17329
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 17330
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665369
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30