CMS Formulary

Displaying 17371-17380 of 1611142 results.
ID: 17371
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 628953
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17372
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 381056
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17373
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 206842
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17374
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17375
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 359296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17376
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 308212
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17377
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 403810
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 17378
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 403811
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 17379
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806195
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17380
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806179
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30