CMS Formulary

Displaying 17391-17400 of 1611142 results.
ID: 17391
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 309335
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17392
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 309336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17393
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 308207
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17394
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17395
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 789980
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17396
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 828755
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17397
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 828539
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17398
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 545835
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17399
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 645884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17400
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 754508
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28