CMS Formulary

Displaying 17461-17470 of 1611142 results.
ID: 17461
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17462
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17463
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17464
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17465
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17466
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 672571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17467
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17468
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17469
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17470
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30