CMS Formulary

Displaying 17531-17540 of 1611142 results.
ID: 17531
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 861597
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17532
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 615882
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17533
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 284496
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17534
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 855926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17535
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 855906
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 17536
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 855664
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 17537
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 995281
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17538
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095227
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17539
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1304988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17540
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84