CMS Formulary

Displaying 17351-17360 of 1611142 results.
ID: 17351
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 763181
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17352
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 763179
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17353
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 763185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17354
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 763183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17355
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 861424
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17356
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1047040
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17357
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1047041
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17358
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1727569
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17359
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 403920
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17360
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 312068
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0