CMS Formulary

Displaying 17511-17520 of 1611142 results.
ID: 17511
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 859044
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17512
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 859048
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17513
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 317110
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17514
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17515
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 858625
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17516
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 855182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17517
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17518
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17519
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17520
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30