CMS Formulary

Displaying 17571-17580 of 1611142 results.
ID: 17571
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 198378
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17572
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1483744
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17573
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 310346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17574
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197319
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17575
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 17576
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197527
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 17577
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197528
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 17578
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197529
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 17579
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 312744
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 17580
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 616487
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30