CMS Formulary

Displaying 17431-17440 of 1611142 results.
ID: 17431
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 857301
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17432
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 857305
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17433
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596780
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 17434
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 855292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17435
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 855306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17436
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 855316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17437
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 855322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17438
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 855328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17439
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 855336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17440
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 855342
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0