CMS Formulary

Displaying 17421-17430 of 1611142 results.
ID: 17421
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 241946
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 17422
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17423
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 308962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17424
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 991039
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17425
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 991194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17426
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 991336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17427
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 991044
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17428
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 991188
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17429
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 584414
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17430
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 857297
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0