CMS Formulary

Displaying 17471-17480 of 1611142 results.
ID: 17471
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17472
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17473
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540356
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17474
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 992475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17475
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 995258
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17476
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297753
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17477
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297757
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17478
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049621
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 17479
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2101899
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17480
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049683
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30