CMS Formulary

Displaying 17331-17340 of 1611142 results.
ID: 17331
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664328
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17332
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664325
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17333
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546083
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 17334
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796091
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17335
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796096
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17336
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862688
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17337
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862701
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17338
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862697
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17339
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862692
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17340
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1037181
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30