CMS Formulary

Displaying 17551-17560 of 1611142 results.
ID: 17551
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 866436
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17552
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 855633
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17553
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607784
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17554
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 199245
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17555
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 199246
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17556
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 199247
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 17557
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 314231
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17558
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 312961
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17559
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198211
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 17560
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 200060
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0