CMS Formulary

Displaying 17481-17490 of 1611142 results.
ID: 17481
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049686
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 17482
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091150
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 17483
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 899557
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17484
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 899518
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17485
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 899548
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17486
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091133
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 17487
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 863664
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17488
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006122
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17489
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055676
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 17490
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30