CMS Formulary

Displaying 17401-17410 of 1611142 results.
ID: 17401
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197411
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17402
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 310600
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17403
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 403850
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17404
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 810090
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17405
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 403851
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17406
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 810083
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17407
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 403852
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17408
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 730988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17409
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 349556
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17410
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 240741
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0